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AV-optimized conduction system pacing for treatment of AV dromotropathy : a randomized, cross-over study
ID
Zupan, Anja
(
Avtor
),
ID
Mrak, Miha
(
Avtor
),
ID
Mullens, Wilfried
(
Avtor
),
ID
Štublar, Jernej
(
Avtor
),
ID
Ivanovski, Maja
(
Avtor
),
ID
Žižek, David
(
Avtor
)
PDF - Predstavitvena datoteka,
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(2,02 MB)
MD5: 3F4FC795B61DA737696BE0828901B563
URL - Izvorni URL, za dostop obiščite
https://onlinelibrary.wiley.com/doi/10.1111/jce.16268
Galerija slik
Izvleček
Background: Severe first-degree atrioventricular (AV) block may produce symptoms similar to heart failure due to AV dyssynchrony, a syndrome termed AV dromotropathy. According to guidelines, it should be considered for permanent pacemaker implantation, yet evidence supporting this treatment is scarce. Objectives: This study aimed to determine the impact of AV-optimized conduction system pacing (CSP) in patients with symptomatic severe first-degree AV block and echocardiographic signs of AV dyssynchrony. Methods: Patients with symptomatic first-degree AV block (PR > 250 ms), preserved left ventricular ejection fraction, narrow QRS, and AV dyssynchrony were included in the study. In a single-blind cross-over design, patients were randomized to AV sequential CSP or backup VVI pacing with a base rate of 40 bpm. We compared exercise capacity, echocardiographic parameters, and symptom occurrence at the end of 3 months of each period. Results: Fourteen patients completed the study. During the AV-optimized CSP compared to the backup pacing period, patients achieved a higher workload on exercise test (147.2 ± 50.9 vs. 140.7 ± 55.8 W; p = .032), with a trend towards higher peak VO2 (23.3 ± 7.1 vs. 22.8 ± 7.1 mL/min/kg; p = .224), and higher left ventricular stroke volume (LVSV 74.5 ± 13.8 vs. 66.4 ± 12.5 mL; p < .001). Symptomatic improvement was recorded, with fewer patients reporting general tiredness and 71% of patients preferring the AV-optimized CSP (p = .008). Conclusions: AV-optimized CSP could improve symptoms, exercise capacity and LVSV in patients with severe first-degree AV block.
Jezik:
Angleški jezik
Ključne besede:
AV coupling
,
AV dromotropathy
,
AV dyssynchrony
,
conduction system pacing
,
first‐degree AV block
Vrsta gradiva:
Članek v reviji
Tipologija:
1.01 - Izvirni znanstveni članek
Organizacija:
MF - Medicinska fakulteta
Status publikacije:
Objavljeno
Različica publikacije:
Objavljena publikacija
Leto izida:
2024
Št. strani:
Str. 1340-1350
Številčenje:
Vol. 35, iss. 7
PID:
20.500.12556/RUL-160166
UDK:
616.1:602.621
ISSN pri članku:
1045-3873
DOI:
10.1111/jce.16268
COBISS.SI-ID:
203663107
Datum objave v RUL:
22.08.2024
Število ogledov:
28
Število prenosov:
3
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Objavi na:
Gradivo je del revije
Naslov:
Journal of cardiovascular electrophysiology
Skrajšan naslov:
J. cardiovasc. electrophysiol.
Založnik:
Wiley
ISSN:
1045-3873
COBISS.SI-ID:
515092
Licence
Licenca:
CC BY-NC-ND 4.0, Creative Commons Priznanje avtorstva-Nekomercialno-Brez predelav 4.0 Mednarodna
Povezava:
http://creativecommons.org/licenses/by-nc-nd/4.0/deed.sl
Opis:
Najbolj omejujoča licenca Creative Commons. Uporabniki lahko prenesejo in delijo delo v nekomercialne namene in ga ne smejo uporabiti za nobene druge namene.
Projekti
Financer:
Drugi - Drug financer ali več financerjev
Program financ.:
University Medical Center Ljubljana
Številka projekta:
TP20190093
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