PMID- 29220422
OWN - NLM
STAT- MEDLINE
DCOM- 20180725
LR  - 20220316
IS  - 1532-2092 (Electronic)
IS  - 1099-5129 (Linking)
VI  - 19
IP  - suppl_4
DP  - 2017 Dec 1
TI  - Atrioventricular node ablation and His bundle pacing.
PG  - iv10-iv16
LID - 10.1093/europace/eux263 [doi]
AB  - AIMS: Atrioventricular node ablation (AVNA) and right ventricular pacing (RVP) 
      are effective therapies for patients with atrial fibrillation (AF) and rapid 
      ventricular rates. His bundle pacing (HBP) is a physiologic alternative to RVP. 
      The aim of our study is to assess the feasibility and safety of HBP in patients 
      undergoing AVNA and its effect on left ventricular (LV) function. METHODS AND 
      RESULTS: Permanent HBP is the preferred form of ventricular pacing at our 
      institute. Atrioventricular node ablation and HBP were performed in patients with 
      AF and difficulty in rate control. His bundle pacing implant characteristics and 
      thresholds were recorded. Fluoroscopic relationship of AVNA site to HBP lead 
      electrodes was documented. Left ventricular ejection fraction (LVEF) and New York 
      Heart Association (NYHA) functional class at baseline and during follow-up were 
      assessed. Forty-two patients underwent HBP and AVNA: age 74 +/- 11 years; men 45%; 
      HTN 64%; DM 19%; CAD 36%; permanent AF 40%; cardiomyopathy 55%. His bundle pacing 
      was successful in 40 of 42 patients (95%). Successful AVNA site was at or below 
      the ring electrode in 22 (no acute change in HBP threshold); above the ring 
      electrode in 13 and left side in 2 pts (acute increase in HBP threshold in 7 of 
      15 pts). Final HBP threshold at implant was 1 +/- 0.8 V@1 ms and increased to 
      1.6 +/- 1.2 V@1 ms during a mean follow-up of 19 +/- 14 months. Left ventricular 
      ejection fraction increased from 43 +/- 13% to 50 +/- 11% (P = 0.01). New York Heart 
      Association functional status improved from 2.5 +/- 0.5 to 1.9 +/- 0.5 (P = 0.04). 
      CONCLUSION: Atrioventricular node ablation and HBP were successful in 95% of 
      patients. His bundle pacing lead characteristics remained relatively stable. Left 
      ventricular ejection fraction improved significantly during follow-up. His bundle 
      pacing is feasible, safe and effective in pts undergoing AVNA.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author 2017. For permissions, please email: journals.permissions@oup.com.
FAU - Vijayaraman, Pugazhendhi
AU  - Vijayaraman P
AD  - Cardiac Electrophysiology, Geisinger Heart Institute, MC 36-10, 1000 E Mountain 
      Blvd, Wilkes-Barre, PA 18711, Pennsylvania.
FAU - Subzposh, Faiz A
AU  - Subzposh FA
AD  - Cardiac Electrophysiology, Geisinger Heart Institute, MC 36-10, 1000 E Mountain 
      Blvd, Wilkes-Barre, PA 18711, Pennsylvania.
FAU - Naperkowski, Angela
AU  - Naperkowski A
AD  - Cardiac Electrophysiology, Geisinger Heart Institute, MC 36-10, 1000 E Mountain 
      Blvd, Wilkes-Barre, PA 18711, Pennsylvania.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
SB  - IM
MH  - Action Potentials
MH  - Aged
MH  - Aged, 80 and over
MH  - Atrial Fibrillation/diagnosis/physiopathology/*therapy
MH  - Atrioventricular Node/physiopathology/*surgery
MH  - Bundle of His/*physiopathology
MH  - Cardiac Pacing, Artificial/adverse effects/*methods
MH  - Catheter Ablation/adverse effects/*methods
MH  - Echocardiography
MH  - Electrocardiography
MH  - Electrophysiologic Techniques, Cardiac
MH  - Feasibility Studies
MH  - Female
MH  - Heart Rate
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Stroke Volume
MH  - Time Factors
MH  - Treatment Outcome
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - AV node ablation
OT  - Heart failure
OT  - His bundle pacing
OT  - Left ventricular function
EDAT- 2017/12/09 06:00
MHDA- 2018/07/26 06:00
CRDT- 2017/12/09 06:00
PHST- 2017/05/14 00:00 [received]
PHST- 2017/07/12 00:00 [accepted]
PHST- 2017/12/09 06:00 [entrez]
PHST- 2017/12/09 06:00 [pubmed]
PHST- 2018/07/26 06:00 [medline]
AID - 4695510 [pii]
AID - 10.1093/europace/eux263 [doi]
PST - ppublish
SO  - Europace. 2017 Dec 1;19(suppl_4):iv10-iv16. doi: 10.1093/europace/eux263.