His bundle pacing versus left bundle branch area pacing in patients undergoing atrioventricular node ablation: A prospective and comparative study

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Archives of Cardiovascular Diseases Pub Date : 2024-08-01 DOI:10.1016/j.acvd.2024.05.118

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引用次数: 0

Abstract

Background

Pacemaker implantation combined with atrioventricular node ablation (AVNA) is a well-established strategy for uncontrolled atrial arrhythmias. Limited data are available regarding His bundle pacing (HBP) and left bundle branch area pacing (LBBAP) in this setting.

Aim

To compare the outcomes of HBP and LBBAP in patients undergoing pacemaker implantation combined with AVN in routine clinical practice.

Methods

We prospectively included all patients who underwent AVNA after successful conduction system pacing (CSP) in two hospitals between September 2017 and May 2023. The primary outcome was the 1-year composite of first episode of heart failure hospitalization, symptomatic atrioventricular node reconduction requiring a second AVNA procedure, lead revision or death from any cause.

Results

A total of 164 patients underwent AVNA following successful CSP (68 HBP and 96 LBBAP). Mean pacemaker implantation and AVNA procedure times were shorter in the LBBAP group than the HBP group (46 ± 18 vs 59 ± 23 min; P < 0.001 and 31 ± 12 vs 43 ± 22 min, respectively; P < 0.001). Complete atrioventricular block was more frequently obtained in the LBBAP group (88/96 patients [92%] vs 54/68 patients [79%]; P = 0.04). One-year freedom from the composite outcome was more frequent in the LBBAP group (89.7% vs 72.9%; hazard ratio 0.32, 95% confidence interval 0.14 − 0.72; P = 0.01). The strategy was similarly effective in both groups with a significant improvement in NYHA class and left ventricular ejection fraction. A secondary pacing threshold elevation >1 V occurred only in the HBP group (11%).

Conclusion

In this prospective, comparative study, LBBAP provided better 1-year outcomes than HBP.

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对接受房室结消融术的患者进行 His 束起搏与左束支区起搏：前瞻性对比研究

背景：起搏器植入术联合房室结消融术（AVNA）是治疗不受控制的房性心律失常的成熟策略。目的：比较在常规临床实践中接受起搏器植入联合房室结消融术的患者接受 HBP 和 LBBAP 治疗的效果：我们前瞻性地纳入了 2017 年 9 月至 2023 年 5 月期间在两家医院成功进行传导系统起搏（CSP）后接受 AVNA 的所有患者。主要结果是首次心衰住院、需要第二次 AVNA 手术的无症状房室结再传导、导联修正或任何原因导致的死亡的 1 年综合结果：共有 164 名患者在 CSP 成功后接受了 AVNA（68 名 HBP 和 96 名 LBBAP）。LBBAP 组的平均起搏器植入时间和 AVNA 手术时间短于 HBP 组（46±18 分钟 vs 59±23 分钟；P1V 仅发生在 HBP 组（11%）：在这项前瞻性比较研究中，LBBAP 的 1 年疗效优于 HBP。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Cardiovascular Diseases 医学-心血管系统

CiteScore

4.40

自引率

6.70%

发文量

审稿时长

34 days

期刊介绍： The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.