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2022-09

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cc-by-nc-nd (c) Pujol López, Margarida et al., 2022
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/216113

Conduction system pacing vs. biventricular pacing in patients with ventricular dysfunction and AV block

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https://doi.org/10.1111/pace.14535

Resum

Background: It is unknown whether His-Purkinje conduction system pacing (HPCSP), as either His bundle or left bundle branch pacing, could be an alternative to cardiac resynchronization therapy (BiVCRT) for patients with left ventricular dysfunction needing ventricular pacing due to atrioventricular block. The aim of the study is to compare the echocardiographic response and clinical improvement between HPCSP and BiVCRT. Methods: Consecutive patients who successfully received HPCSP were compared with a historical cohort of BiVCRT patients. Patients were 1:1 matched by age, LVEF, atrial fibrillation, renal function and cardiomyopathy type. Responders were defined as patients who survived, did not require heart transplantation and increased LVEF ≥5 points at 6-month follow-up. Results: HPCSP was successfully achieved in 92.5% (25/27) of patients. During follow-up, 8% (2/25) of HPCSP patients died and 4% (1/25) received a heart transplant, whereas 4% (1/25) of those in the BiVCRT cohort died. LVEF improvement was 10% ± 8% HPCSP versus 7% ± 5% BiVCRT (p = .24), and the percentage of responders was 76% (19/25) HPCSP versus 64% (16/25) BiVCRT (p = .33). Among survivors, the percentage of patients who improved from baseline II-IV mitral regurgitation (MR) to 0-I MR was 9/11 (82%) versus 2/8 (25%) (p = .02). Compared to those with BiVCRT, patients with HPCSP achieved better NYHA improvement: 1 point versus 0.5 (OR 0.34; p = .02). Conclusion: HPCSP in patients with LVEF ≤45% and atrioventricular block improved the LVEF and induced a response similar to that of BiVCRT. HPCSP significantly improved MR and NYHA functional class. HPCSP may be an alternative to BiVCRT in these patients. (Figure 1. Central Illustration). [Figure: see text].

Matèries

Insuficiència cardíaca, Ventricles cardíacs, Avaluació de resultats (Assistència mèdica), Efectes secundaris

Matèries (anglès)

Heart failure, Ventricle of heart, Outcome assessment (Medical care), Side effects

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Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

PUJOL LÓPEZ, Margarida, JIMÉNEZ ARJONA, Rafael, GUASCH I CASANY, Eduard, BORRÀS, Roger, DOLTRA, Adelina, VÁZQUEZ CALVO, Sara, ROCA LUQUE, Ivo, GARRE ANGUERA DE SOJO, Paz, FERRÓ, Elisenda, NIEBLA BELLIDO, Mireia, CARRO, Esther, PUENTE, Jose l., URIBE, Laura, INVERS, Eric, CASTEL LAVILLA, Maria àngels, ARBELO, Elena, SITGES CARREÑO, Marta, MONT GIRBAU, Lluís, TOLOSANA, José m. (josé maría). Conduction system pacing vs. biventricular pacing in patients with ventricular dysfunction and AV block. _Pace-Pacing and Clinical Electrophysiology_. 2022. Vol. 45, núm. 9, pàgs. 1115-1123. [consulta: 21 de gener de 2026]. ISSN: 0147-8389. [Disponible a: https://hdl.handle.net/2445/216113]

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