Background: Conduction system pacing (CSP), including His-bundle pacing (HBP) and left bundle branch area pacing (LBBAP), have been proposed as alternatives to biventricular pacing (BVP) in patients scheduled for ablate and pace (A&P) strategy. The aim of this study was to compare the clinical outcomes, including the rate and nature of device-related complications, between BVP and CSP in a cohort of patients undergoing A&P.
Methods: Prospective, multicenter, observational study, enrolling consecutive patients undergoing A&P. The risk of device-related complications and of heart failure (HF) hospitalization was prospectively assessed.
Results: A total of 373 patients (75.3 ± 8.7 years, 53.9% male, 68.9% with NYHA class ≥III) were enrolled: 263 with BVP, 68 with HBP, and 42 with LBBAP. Baseline characteristics of the three groups were similar. Compared to BVP and HBP, LBBAP was associated with the shortest mean procedural and fluoroscopy times and with the lowest acute capture thresholds (all p < .05). At 12-month follow-up LBBAP maintained the lowest capture thresholds and showed the longest estimated residual battery longevity (all p < .05). At 12-months follow-up the three study groups showed a similar risk of device-related complications (5.7%, 4.4%, and 2.4% for BVP, HBP, and LBBAP, respectively; p = .650), and of HF hospitalization (2.7%, 1.5%, and 2.4% for BVP, HBP, and LBBAP, respectively; p = .850).
Conclusions: In the setting of A&P, CSP is a feasible pacing modality, with a midterm safety profile comparable to BVP. LBBAP offers the advantage of reducing procedural times and obtaining lower and stable capture thresholds, with a positive impact on the device longevity.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/pace.14813 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Atrial pace mapping using automatic intracardiac pattern matching for ablation of non-sustained atrial tachycardia: a case report.
HeartRhythm Case Rep
November 2024
Department of Internal Medicine III, Cardiology and Angiology, University Hospital Schleswig-Holstein, Kiel, Germany.
Multistep Algorithm to Predict RVOT PVC Site of Origin for Successful Ablation Using Available Criteria: A Two-Center Cross-Validation Study.
Pacing Clin Electrophysiol
December 2024
Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Background: Predicting premature ventricular contraction (PVC) origin pre-ablation is a fundamental step, as right ventricular outflow tract (RVOT) PVC often leads to higher success rates.
Objective: To compare nine published ECG criteria to differentiate between RVOT and non-RVOT origins of PVCs and develop a stepwise algorithm using those criteria to better determine PVC origin to predict ablation success.
Methods: Two centers were involved in this study, the derivation group and the validation group.
Transseptal Sheath Perfused with High Concentration Heparinized Saline for Reducing Sheath-associated Thrombus.
Pacing Clin Electrophysiol
December 2024
Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Article Synopsis
- The study focused on the use of transseptal sheaths (TSS) for atrial fibrillation (AF) ablation, aiming to prevent thromboembolism through a simple saline flush management technique.
- In the retrospective study involving over 4,700 AF patients, complications were low, with no acute strokes, and only a few thromboembolic issues occurring post-procedure.
- The prospective study showed no thrombus formation in 127 procedures using high concentration heparinized saline, demonstrating that this method is both safe and effective for preventing thrombus during AF radiofrequency ablation.
Comparison of Procedural Outcomes of Lumenless Fixed-Helix Versus Stylet-Driven Extendable-Helix Lead Systems in Left Bundle Branch Pacing: COMPARE LBBP.
Circ Arrhythm Electrophysiol
December 2024
The School of Medicine and Psychology, Australian National University, Australian Capital Territory (J.P.S., A.N., D.C.R., W.P.A., R.K.P.).
Background: Left bundle branch pacing (LBBP) has emerged as a safe and effective alternative to right ventricular pacing. Traditionally, LBBP is performed with lumenless lead (LLL); however, the use of stylet-driven lead (SDL) is on rise. We aimed to assess acute success and procedural outcomes of SDL versus LLL for LBBP.
View Article and Find Full Text PDFDistinguishing Wolff-Parkinson-White Syndrome From Fasciculoventricular Pathway Using QRS-T Angle Analysis.
Pacing Clin Electrophysiol
November 2024
Division of Pediatric Electrophysiology, Pediatric Medical Care Center, Osaka City General Hospital, Osaka, Japan.
Article Synopsis
- Wolff-Parkinson-White (WPW) syndrome and fasciculoventricular pathway (FVP) both show delta waves on an ECG, but distinguishing between them, especially WPW type B, can be complex due to similar features.
- A study analyzed 40 WPW patients and 54 FVP patients to assess the QRS-T angle, resulting in a significantly larger QRS-T angle in the WPW group (45.7°) compared to FVP (17.8°).
- The research suggests that the QRS-T angle could be a useful marker for differentiating WPW syndrome from FVP, with a cut-off value of 22°
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!