PMID- 33395736
OWN - NLM
STAT- MEDLINE
DCOM- 20210701
LR  - 20210701
IS  - 2055-5822 (Electronic)
IS  - 2055-5822 (Linking)
VI  - 8
IP  - 2
DP  - 2021 Apr
TI  - Impact of QRS morphology on response to conduction system pacing after 
      atrioventricular junction ablation.
PG  - 1195-1203
LID - 10.1002/ehf2.13181 [doi]
AB  - AIMS: His-Purkinje conduction system pacing (HPCSP) utilizing His (HBP) or left 
      bundle branch pacing (LBBP) in patients with atrial fibrillation (AF) and wide 
      QRS duration has not been well studied. We assessed the benefit of left bundle 
      branch block (LBBB) correction during HPCSP in AF patients undergoing 
      atrioventricular junction (AVJ) ablation with LBBB, compared with those with 
      narrow QRS duration. METHODS AND RESULTS: This is an observational study in 
      consecutive patients with typical LBBB or narrow QRS duration in whom we 
      attempted HPCSP after AVJ ablation for refractory AF with a left ventricular 
      ejection fraction (LVEF) </= 50%. Echocardiographic responses and clinical outcomes 
      were assessed at baseline and during 1 year of follow-up. A total of 178 patients 
      were enrolled, of which 170 achieved AVJ ablation + permanent HPCSP (age 
      69.3 +/- 10.1 years; LVEF 34.3 +/- 7.7%), 133 (78.2%) patients had a narrow QRS 
      duration, and 37 (21.2%) had an LBBB. The QRS duration changed from a baseline of 
      159.7 +/- 16.6 ms to a paced QRS duration of 110.4 +/- 12.7 ms in the LBBB cohort and 
      from 95.6 +/- 10.4 to 100.8 +/- 14.5 ms (both P < 0.001) in the narrow QRS cohort 
      after AVJ ablation and pacing. Compared with the narrow QRS cohort, the LBBB 
      cohort showed a greater absolute increase in LVEF (+22.3% vs. +14.2%, P < 0.001), 
      higher super responder rate (71.4% vs. 49.2%, P = 0.011), and greater New York 
      Heart Association (NYHA) class improvement (-1.9 vs. -1.4, P < 0.001) at 1 year. 
      CONCLUSION: Patients with LBBB have greater improvement in LVEF and NYHA class 
      function than patients with narrow QRS from HPCSP after AVJ ablation.
CI  - (c) 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on 
      behalf of European Society of Cardiology.
FAU - Wu, Shengjie
AU  - Wu S
AD  - Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, 325000, China.
AD  - The Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, 325000, China.
FAU - Cai, Mengxing
AU  - Cai M
AD  - Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, 325000, China.
AD  - The Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, 325000, China.
FAU - Zheng, Rujie
AU  - Zheng R
AD  - Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, 325000, China.
AD  - The Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, 325000, China.
FAU - Wang, Songjie
AU  - Wang S
AD  - Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, 325000, China.
AD  - The Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, 325000, China.
FAU - Jiang, Limeng
AU  - Jiang L
AD  - Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, 325000, China.
AD  - The Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, 325000, China.
FAU - Xu, Lei
AU  - Xu L
AD  - Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, 325000, China.
AD  - The Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, 325000, China.
FAU - Shi, Ruiyu
AU  - Shi R
AD  - Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, 325000, China.
AD  - The Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, 325000, China.
FAU - Xiao, Fangyi
AU  - Xiao F
AD  - Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, 325000, China.
AD  - The Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, 325000, China.
FAU - Ellenbogen, Kenneth A
AU  - Ellenbogen KA
AD  - Department of Cardiology, Virginia Commonwealth University Health System, 
      Richmond, VA, USA.
FAU - Cha, Yongmei
AU  - Cha Y
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
FAU - Su, Lan
AU  - Su L
AD  - Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, 325000, China.
AD  - The Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, 325000, China.
FAU - Huang, Weijian
AU  - Huang W
AD  - Department of Cardiology, The First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, 325000, China.
AD  - The Key Lab of Cardiovascular Disease of Wenzhou, Wenzhou, 325000, China.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20210104
PL  - England
TA  - ESC Heart Fail
JT  - ESC heart failure
JID - 101669191
SB  - IM
MH  - Aged
MH  - *Bundle of His/surgery
MH  - Bundle-Branch Block/diagnosis/therapy
MH  - *Cardiac Pacing, Artificial
MH  - Humans
MH  - Middle Aged
MH  - Stroke Volume
MH  - Ventricular Function, Left
PMC - PMC8006676
OTO - NOTNLM
OT  - Atrial fibrillation
OT  - Atrioventricular junction ablation
OT  - His bundle pacing
OT  - His-Purkinje conduction system pacing
OT  - Left bundle branch block
OT  - Left bundle branch pacing
COIS- None declared.
EDAT- 2021/01/05 06:00
MHDA- 2021/07/02 06:00
PMCR- 2021/01/04
CRDT- 2021/01/04 20:07
PHST- 2020/11/16 00:00 [revised]
PHST- 2020/07/19 00:00 [received]
PHST- 2020/12/08 00:00 [accepted]
PHST- 2021/01/05 06:00 [pubmed]
PHST- 2021/07/02 06:00 [medline]
PHST- 2021/01/04 20:07 [entrez]
PHST- 2021/01/04 00:00 [pmc-release]
AID - EHF213181 [pii]
AID - 10.1002/ehf2.13181 [doi]
PST - ppublish
SO  - ESC Heart Fail. 2021 Apr;8(2):1195-1203. doi: 10.1002/ehf2.13181. Epub 2021 Jan 
      4.