Arrhythmias & electrophysiology
His-bundle pacing and atrioventricular nodal ablation for noncontrolled atrial arrhythmia: A technical challenge with major clinical benefits
Authors' conclusion
AVNA combined with HBP for noncontrolled atrial arrhythmia was feasible and clinically efficient.
Study context
- Population
- Patients with uncontrolled atrial arrhythmia undergoing atrioventricular nodal ablation (AVNA) after his-bundle pacing (HBP), 2017–2022
- Participants
- 75 patients
- Outcome
- Feasibility and efficacy of AVNA combined with HBP
Methodological detailsmulticentre (3 hospitals)
- Multicentre (3 hospitals)
Main finding
As reported in the abstract
AVNA result
| Group | Complete atrioventricular (AV) block | Significant AV nodal modulation (HR <60 bpm) | AVNA failure |
|---|---|---|---|
| HBP + AVNA | 58 (77%) | 12 (16%) | 5 (7%) |
HBP + AVNA
Complete atrioventricular (AV) block58 (77%)
Significant AV nodal modulation (HR <60 bpm)12 (16%)
AVNA failure5 (7%)
Observational data: associations, not effects.
Further findings
AVNA modulation/failure vs Complete AV block
| Outcome | AVNA modulation/failure | Complete AV block | P value |
|---|---|---|---|
| Atrial signal recorded by HBP lead, AVNA modulation/failure vs complete AV block | 11/17 | 5/58 | P < 0.001 |
Last follow-up vs Baseline
| Outcome | Baseline | Last follow-up | P value |
|---|---|---|---|
| NYHA functional class, baseline vs last follow-up | 3.0 ± 0.7 | 1.6 ± 0.5 | P < 0.001 |
| LVEF, baseline vs last follow-up | 47% ± 14% | 60% ± 9% | P < 0.0001 |
Safety
Lead dislodgment during AVNA
- No lead dislodgment occurred during the AVNA procedures
Acute His-bundle (HB) capture threshold increase >1 V
- Patients with acute HB capture threshold increase >1 V
- 11 (15%)
- Return to baseline value on day 1
- 9 patients
Original publication
His-bundle pacing and atrioventricular nodal ablation for noncontrolled atrial arrhythmia: A technical challenge with major clinical benefits. Heart Rhythm. Published 20 December 2022. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →