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Acute echocardiogra...
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Loring, ZakDuke Clinical Research Institute (DCRI),Duke University
(author)
Acute echocardiographic and hemodynamic response to his-bundle pacing in patients with first-degree atrioventricular block
- Article/chapterEnglish2022
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LIBRIS-ID:oai:lup.lub.lu.se:08f58af7-908b-4568-9936-1c9b585c7e10
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https://lup.lub.lu.se/record/08f58af7-908b-4568-9936-1c9b585c7e10URI
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https://doi.org/10.1111/anec.12954DOI
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Language:English
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Summary in:English
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Subject category:art swepub-publicationtype
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Subject category:ref swepub-contenttype
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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.
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Holmqvist, FredrikLund 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(Swepub:lu)kard-fho
(author)
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Sze, EdwardDuke University,Maine Medical Center
(author)
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Alenezi, FawazDuke University
(author)
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Campbell, KristenDuke University Medical Center,Maine Medical Center
(author)
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Koontz, Jason I.Duke University
(author)
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Velazquez, Eric J.Yale University,Duke University
(author)
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Atwater, Brett D.Duke University,Inova Heart and Vascular Institute
(author)
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Bahnson, Tristram D.Duke University
(author)
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Daubert, James P.Duke University
(author)
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Duke Clinical Research Institute (DCRI)Duke University
(creator_code:org_t)
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In:Annals of Noninvasive Electrocardiology: Wiley27:41082-720X1542-474X
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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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Velazquez, Eric ...
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Atwater, Brett D ...
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Daubert, James P ...
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