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Ablate and pace strategy for atrial fibrillation: pacing modalities, ablation approaches and impact on patient outcomes.
Expert Rev Med Devices
January 2025
Cardiology Unit, "Card. G. Panico" Hospital, Tricase (Le), Italy.
Introduction: In patients with symptomatic, refractory atrial fibrillation the ablate and pace (A&P) strategy (pacemaker implantation followed by atrio-ventricular junction ablation (AVJA)) is superior to medical therapy in improving quality of life and prognosis. Despite its well-proven benefits, this invasive therapeutic option is still underutilized in clinical practice. The choice of pacing modality (right ventricular pacing, biventricular pacing, BVP, or conduction system pacing, CSP) is crucial and can have significant clinical implications.
View Article and Find Full Text PDFInteratrial block is an independent risk factor for new-onset atrial fibrillation after cardiac surgery.
JTCVS Open
December 2024
Department of Cardiac Surgery, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany.
Objectives: This study aims to investigate the association between interatrial conduction block and postoperative atrial fibrillation, which can precipitate acute cardiopulmonary instability and is associated with subsequent heart failure, stroke, and mortality following cardiac surgery.
Methods: Perioperative 12-channel electrocardiograms from 3405 patients undergoing myocardial revascularization, valve surgery, aortic surgery, or combinations thereof, were considered. Clinical and electrographic parameters were compared between patients with and without atrial fibrillation, and significant variables were analyzed using univariate and multivariate logistic regression.
Left Bundle Branch Area Pacing Versus Right Ventricular Pacing in Patients With Atrioventricular Block: A Systematic Review and Meta-Analysis.
J Cardiovasc Electrophysiol
January 2025
Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Background: Left bundle branch area pacing (LBBAP) is a new technique for patients with atrioventricular block (AVB) and preserved left ventricular ejection fraction (LVEF), potentially offering better cardiac function than right ventricular pacing (RVP).
Methods: We searched databases and registries for studies that compared LBBAP with RVP in patients with AVB and preserved LVEF. We extracted data on various outcomes and pooled the effect estimates using random-effects models.
The Relationship Between the Kansas City Cardiomyopathy Questionnaire and Electrocardiographic Parameters in Predicting Outcomes After Cardiac Resynchronization Therapy.
Life (Basel)
November 2024
Department of Cardiology, Bagdasar-Arseni Emergency Hospital, Carol Davila University of Medicine and Pharmacy, 022328 Bucharest, Romania.
Background: Cardiac resynchronization therapy (CRT) is an essential treatment for patients with symptomatic heart failure and ventricular conduction abnormalities. Low-ejection-fraction (EF) cardiomyopathy often involves a wide QRS complex displaying a left bundle branch block (LBBB) morphology and markedly delayed activation of the LV lateral wall. Following CRT, patients with heart failure and LBBB have better outcomes and quality-of-life improvements.
View Article and Find Full Text PDFConduction disease in cardiac amyloidosis patients: A case series suggesting a role for left bundle branch area pacing.
Indian Pacing Electrophysiol J
January 2025
Royal Jubilee Hospital, Vancouver Island Health Authority, British Columbia, Canada.
Transthyretin Cardiac amyloidosis (ATTR-CA) is an increasingly recognised cause of heart failure in our elderly patients with preserved ejection fraction. Patients with ATTR-CA who require permanent pacemaker implantation often have preserved ejection fraction and do not meet the clinical indication for cardiac resynchronization therapy (CRT). In these patients, left bundle branch area pacing (LBBAP) can be a reasonable option to maximise physiological activation of the left ventricle.
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