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Acute echocardiogra...
Acute echocardiographic and hemodynamic response to his-bundle pacing in patients with first-degree atrioventricular block
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- Loring, Zak (author)
- Duke Clinical Research Institute (DCRI),Duke University
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- Holmqvist, Fredrik (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Electrocardiology Research Group - CIEL,Forskargrupper vid Lunds universitet,Clinical studies af Atrial Fibrillation,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups,Duke University
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- Sze, Edward (author)
- Duke University,Maine Medical Center
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- Alenezi, Fawaz (author)
- Duke University
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- Campbell, Kristen (author)
- Duke University Medical Center,Maine Medical Center
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- Koontz, Jason I. (author)
- Duke University
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- Velazquez, Eric J. (author)
- Yale University,Duke University
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- Atwater, Brett D. (author)
- Duke University,Inova Heart and Vascular Institute
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- Bahnson, Tristram D. (author)
- Duke University
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- Daubert, James P. (author)
- Duke University
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(creator_code:org_t)
- 2022-04-21
- 2022
- English.
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In: Annals of Noninvasive Electrocardiology. - : Wiley. - 1082-720X .- 1542-474X. ; 27:4
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Abstract
Subject headings
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- Background: Atrial pacing and right ventricular (RV) pacing are both associated with adverse outcomes among patients with first-degree atrioventricular block (1°AVB). His-bundle pacing (HBP) provides physiological activation of the ventricle and may be able to improve both atrioventricular (AV) and inter-ventricular synchrony in 1°AVB patients. This study evaluates the acute echocardiographic and hemodynamic effects of atrial, atrial-His-bundle sequential (AH), and atrial-ventricular (AV) sequential pacing in 1°AVB patients. Methods: Patients with 1°AVB undergoing atrial fibrillation ablation were included. Following left atrial (LA) catheterization, patients underwent atrial, AH- and AV-sequential pacing. LA/left ventricular (LV) pressure and echocardiographic measurements during the pacing protocols were compared. Results: Thirteen patients with 1°AVB (mean PR 221 ± 26 ms) were included. The PR interval was prolonged with atrial pacing compared to baseline (275 ± 73 ms, p =.005). LV ejection fraction (LVEF) was highest during atrial pacing (62 ± 11%), intermediate with AH-sequential pacing (59 ± 7%), and lowest with AV-sequential pacing (57 ± 12%) though these differences were not statistically significant. No significant differences were found in LA or LV mean pressures or LV dP/dT. LA and LV volumes, isovolumetric times, electromechanical delays, and global longitudinal strains were similar across pacing protocols. Conclusion: Despite pronounced PR prolongation, the acute effects of atrial pacing were not significantly different than AH- or AV-sequential pacing. Normalizing atrioventricular and/or inter-ventricular dyssynchrony did not result in acute improvements in cardiac output or loading conditions.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- echocardiography
- EP study
- first-degree AV-block
- His-bundle
- pacing
Publication and Content Type
- art (subject category)
- ref (subject category)
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- By the author/editor
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Loring, Zak
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Holmqvist, Fredr ...
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Sze, Edward
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Alenezi, Fawaz
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Campbell, Kriste ...
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Koontz, Jason I.
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show more...
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Velazquez, Eric ...
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Atwater, Brett D ...
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Bahnson, Tristra ...
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Daubert, James P ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Annals of Noninv ...
- By the university
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Lund University