Long‐Term Results of Atrioventricular Node Ablation After His Bundle Pacing in Uncontrolled Atrial Tachyarrhythmias.
Introduction: In the evolving treatment of atrial fibrillation (AF), atrioventricular (AV) node ablation is being reconsidered as an early option for patients with inadequate AF control and limited cure potential. Although interest in physiological pacing is growing, concerns about the long‐term saf...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 48; no. 7; pp. 799 - 807 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | diagnostic images research tables/charts tracings Journal Article |
| Publicado: |
Wiley-Blackwell
Jul2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=186991085&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 186991085 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Jul2025 vid: 48 iid: 7 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 186991085 186010397 186991085 186991085 10.1111/pace.70000 186991085 ppf: 799 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Long‐Term Results of Atrioventricular Node Ablation After His Bundle Pacing in Uncontrolled Atrial Tachyarrhythmias. aug: au: Moraleda‐Salas, María Teresa Erkoreka‐Gasituaga, Ane Perea‐Alfaro, Carlos Esteve‐Ruiz, Irene Arce‐León, Álvaro Carreño‐Lineros, José Miguel Amigo‐Otero, Emilio Moraleda‐Salas, María del Mar Camacho‐Freire, Santiago Navarro‐Roldan, Francisco Moriña‐Vázquez, Pablo affil: Arrhythmia Unit, Department of Cardiology, Hospital Juan Ramon Jimenez, Huelva, Spain sug: subj: Atrioventricular Node Physiopathology Catheter Ablation Methods Ablation Techniques Tachycardia Surgery Atrial Fibrillation Surgery Atrioventricular Node Surgery Bundle of HIS Physiopathology Cardiac Pacing, Artificial Methods Treatment Outcomes Ventricular Ejection Fraction Readmission Cardiac Resynchronization Therapy Human Male Female Aged Aged, 80 and Over Descriptive Research Nonexperimental Studies Heart Rate Prospective Studies Postoperative Complications Tachycardia Drug Therapy Antiarrhythmia Agents Therapeutic Use Aged: 65+ years Aged, 80 & over Male Female ab: Introduction: In the evolving treatment of atrial fibrillation (AF), atrioventricular (AV) node ablation is being reconsidered as an early option for patients with inadequate AF control and limited cure potential. Although interest in physiological pacing is growing, concerns about the long‐term safety of permanent His bundle pacing (p‐HBP) persist. Our current study aims to evaluate the long‐term outcomes of patients who underwent AV node ablation and p‐HBP, focusing on left ventricular ejection fraction (LVEF), NYHA class, readmissions, and pacing parameters. Methods: This descriptive observational study involved patients with uncontrolled permanent atrial arrhythmias who were eligible for heart rate (HR) control (between January 2019 and July 2020) and underwent p‐HBP and AV node ablation, followed during a near 4‐year period. Results: We conducted a long‐term follow‐up study with a median duration of 47 months on 32 patients who received p‐HBP followed by AV node ablation. The average age was 77 years, predominantly female (65.6%), with a high prevalence of hypertension (90.6%). The main indications for ablation were uncontrolled AF (59.4%) and atypical atrial flutter (37.5%). At baseline, the median LVEF was 60%. Notably, LVEF improved significantly from 45% to 50% in those with reduced baseline function (p < 0.05). NYHA class improvements were also observed over time. The His thresholds remained similar during long‐term follow‐up, being 1.25 V at 0.4 ms (1.25–2.4 V at 0.4 ms) before AV node ablation and 1.30 V at 0.4 ms (0.75–2.25 V at 0.4 ms), p = 0.89, at long‐term follow‐up. The impedances remained stable. No complications related to the pacemaker occurred. Number of medications per patient for HR control significantly decreased from 1.6 to 0.37 (p < 0.05), while hospital admissions for tachyarrhythmias dropped markedly. There was one death during the follow‐up due to cancer, but conclusions regarding mortality are limited by the small sample size. Conclusions: AV node ablation and p‐HBP significantly improve functional class and LVEF, with benefits maintained over time. Patients experience fewer emergency visits and reduced HR medication. Pacing parameters remained stable during long‐term follow‐up. pubtype: Academic Journal doctype: diagnostic images research tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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