Abstract:
INTRODUCTION:In patients with sinus node disease (SND), the dual-chamber pacemaker (PM) is programmed in DDDR mode with an algorithm to avoid unnecessary right ventricular (RV) pacing. This pacing mode may prolong PR interval with consequently atrioventricular (AV) asynchrony which is associated with a higher risk of atrial fibrillation (AF). We evaluate whether preserving AV synchrony by setting a fixed AV delay during physiological RV pacing, that is, His bundle pacing (HBP), could reduce the risk of AF occurrence in comparison with a standard pacing mode with an algorithm to avoid unnecessary RV pacing (DDD-VPA). METHODS AND RESULTS:We collected retrospective data from 313 consecutive patients who had undergone PM for SND. The first occurrence of persistent AF (>7 consecutive days) as a function of the pacing mode was evaluated. HBP and DDD-VPA were implemented in 82 and 231 patients, respectively. Persistent AF occurred in 128 (40.9%) patients over a median follow-up of 70 months (67-105). The DDD-VPA pacing mode was significantly correlated with the occurrence of persistent AF only when the basal PR was long (>180 ms). The risk of persistent AF was significantly lower in patients on HBP than in those on DDD-VPA, adjusted HR = .57 (95% CI, .36- .89, p=.014). Other independent predictors of persistent AF occurrence were: A history of AF (HR = 3.91; 95% CI, 2.48-6.19, p = .001), age, and long PR interval (HR = 2.98; 95% CI, 2.00-4.43, p=.001). CONCLUSION:In SND patients and long basal PR interval, the HBP may reduce the risk of persistent AF in comparison with the DDD-VPA.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Pastore G,Marcantoni L,Lanza D,Maines M,Noventa F,Corbucci G,Rigatelli G,Baracca E,Roncon L,Zanon Fdoi
10.1111/jce.14810subject
Has Abstractpub_date
2020-11-11 00:00:00eissn
1045-3873issn
1540-8167pub_type
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journal_title:Journal of cardiovascular electrophysiology
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journal_title:Journal of cardiovascular electrophysiology
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journal_title:Journal of cardiovascular electrophysiology
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pub_type: 杂志文章
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journal_title:Journal of cardiovascular electrophysiology
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
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更新日期:2019-08-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13697
更新日期:2018-10-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
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abstract:BACKGROUND:Evaluation of ventricular rate control in atrial fibrillation (AF) can be difficult, and the presence of an AF-induced ventricular cardiomyopathy due to intermittent poor rate control or other causes may be underestimated. The outcome with AF ablation in patients with a decreased left ventricular ejection fr...
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journal_title:Journal of cardiovascular electrophysiology
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journal_title:Journal of cardiovascular electrophysiology
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1998.tb00946.x
更新日期:1998-06-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
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