Retrograde penetration pacing into the conduction system as an alternative approach of his-bundle pacing
| Autor: | Kohei Ishibashi, Kenzaburo Nakajima, Takeshi Aiba, Takashi Noda, Koji Miyamoto, Mitsuru Wada, Satoshi Nagase, Keisuke Kiso, Yoshifumi Nouno, Yuko Inoue, Kenichiro Yamagata, Tsukasa Kamakura, Nobuhiko Ueda, Kengo Kusano |
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| Rok vydání: | 2022 |
| Předmět: |
Bradycardia
Cardiac function curve medicine.medical_specialty business.industry Atrial fibrillation medicine.disease QRS complex Narrow qrs Late phase Baseline characteristics Internal medicine cardiovascular system medicine Cardiology cardiovascular diseases medicine.symptom Electrical conduction system of the heart Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiology. 79:127-133 |
| ISSN: | 0914-5087 |
| Popis: | Background : The optimal right ventricular (RV) pacing site during pacemaker implantation is still unclear due to left ventricular (LV) dyssynchrony by traditional RV pacing. His-bundle (HIS) pacing has achieved narrow QRS and maintained LV synchrony but high failure rate. RV septal pacing occasionally has QRS waveform with wide and narrow component in the early and late phase, respectively, and maintains LV synchrony, reflecting the normal conduction system. We aimed to define this QRS waveform as retrograde penetration pacing into the conduction system (RPP-CS) and compared its effect on LV synchrony as an alternative approach of HIS pacing. Methods and Results : We enrolled 42 patients with atrio ventricular block (AVB) or bradycardia atrial fibrillation (AF) requiring pacemaker implantation (RPP-CS, n = 27; no RPP-CS, n = 15). Baseline characteristics were similar between the groups. RPP-CS was observed in 96% and 26% of the RV septum and apex area, respectively. RPP-CS had a significantly shorter QRS width (p Conclusions : RPP-CS, especially with short QRS intervals (≤132 ms), had a high frequency of LV synchrony, maintained postoperative cardiac function, and may be an adequate first-line RV pacing site strategy for AVB or bradycardia AF as an alternative approach of HIS pacing. |
| Databáze: | OpenAIRE |
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