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Single-center experience of efficacy and safety of atrioventricular node ablation after left bundle branch area pacing for the management of atrial fibrillation.
Jacobs, Mathieu; Bodin, Alexandre; Spiesser, Pascal; Babuty, Dominique; Clementy, Nicolas; Bisson, Arnaud.
Afiliación
  • Jacobs M; University Hospital of Tours, Avenue de la république, Chambray-Les-Tours, 37170, France. mathieu.jacobs@etu.univ-tours.fr.
  • Bodin A; University Hospital of Tours, Avenue de la république, Chambray-Les-Tours, 37170, France.
  • Spiesser P; University Hospital of Orleans, 14 Avenue de l'Hopital, Orleans, 45100, France.
  • Babuty D; University Hospital of Tours, Avenue de la république, Chambray-Les-Tours, 37170, France.
  • Clementy N; Clinic du Millenaire, 220 Boulevard Penelope, Montpellier, 34000, France.
  • Bisson A; University Hospital of Tours, Avenue de la république, Chambray-Les-Tours, 37170, France.
J Interv Card Electrophysiol ; 2024 Jun 24.
Article en En | MEDLINE | ID: mdl-38913133
ABSTRACT

BACKGROUND:

Atrioventricular node ablation (AVNA) with permanent pacing is an effective treatment of symptomatic atrial fibrillation (AF). Left bundle branch area pacing (LBBAP) prevents cardiac dyssynchrony associated with right ventricular pacing and could prevent worsening of heart failure (HF).

METHODS:

In this retrospective monocentric study, all patients who received AVNA procedure with LBBAP were consecutively included. AVNA procedure data, electrical and echocardiographic parameters at 6 months, and clinical outcomes at 1 year were studied and compared to a matched cohort of patients who received AVNA procedure with conventional pacing between 2010 and 2023.

RESULTS:

Seventy-five AVNA procedures associated with LBBAP were studied. AVNA in this context was feasible, with a success rate of 98.7% at first ablation, and safe without any complications. There was no threshold rise at follow-up. At 1 year, 6 (8%) patients were hospitalized for HF and 2 (2.7%) were deceased. Patients had a significant improvement in NYHA class and left ventricular ejection fraction (LVEF) (P ≤ 0.0001). When compared to a matched cohort of patients with AVNA and conventional pacing, AVNA data and pacing complications rates were similar. Patients with LBBAP had a better improvement of LVEF (+5.27 ± 9.62% vs. -0.48 ± 14%, P = 0.01), and a lower 1-year rate of composite outcome of hospitalization for HF or death (HR 0.39, 95% CI 0.16-0.95, P = 0.037), significant on survival analysis (log-rank P-value = 0.03).

CONCLUSION:

AVNA with LBBAP in patients with symptomatic AF is feasible, safe, and efficient. Hospitalization for HF or death rate was significantly lower and LVEF improvement was greater.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Interv Card Electrophysiol Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Interv Card Electrophysiol Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Países Bajos