The role of conduction system pacing in patients with atrial fibrillation

被引:2
|
作者
Wijesuriya, Nadeev [1 ,2 ]
Mehta, Vishal [1 ,2 ]
De Vere, Felicity [1 ,2 ]
Strocchi, Marina [1 ]
Behar, Jonathan M. [1 ,2 ]
Niederer, Steven A. [1 ,3 ]
Rinaldi, Christopher A. [1 ,2 ]
机构
[1] Kings Coll London, Sch Biomed Engn & Imaging Sci, London, England
[2] Guys & St Thomas NHS Fdn Trust, Dept Cardiol, London, England
[3] Alan Turing Inst, Res & Innovat Cluster, London, England
来源
基金
美国国家卫生研究院; 英国工程与自然科学研究理事会; 欧洲研究理事会;
关键词
left bundle area pacing; his bundle pacing; atrial fibrillation; cardiac resynchonization therapy; heart failiure; AV nodal ablation; CARDIAC RESYNCHRONIZATION THERAPY; ATRIOVENTRICULAR NODE ABLATION; HIS-BUNDLE; HEART-FAILURE; JUNCTION ABLATION; GUIDELINES; IMPACT; RHYTHM;
D O I
10.3389/fcvm.2023.1187754
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Conduction system pacing (CSP) has emerged as a promising novel delivery method for Cardiac Resynchronisation Therapy (CRT), providing an alternative to conventional biventricular epicardial (BiV) pacing in indicated patients. Despite increasing popularity and widespread uptake, CSP has rarely been specifically examined in patients with atrial fibrillation (AF), a cohort which forms a significant proportion of the heart failure (HF) population. In this review, we first examine the mechanistic evidence for the importance of sinus rhythm (SR) in CSP by allowing adjustment of atrioventricular delays (AVD) to achieve the optimal electrical response, and thus, whether the efficacy of CSP may be significantly attenuated compared to conventional BiV pacing in the presence of AF. We next evaluate the largest clinical body of evidence in this field, related to patients receiving CSP following atrioventricular nodal ablation (AVNA) for AF. Finally, we discuss how future research may be designed to address the vital question of how effective CSP in AF patients is, and the potential hurdles we may face in delivering such studies.
引用
收藏
页数:8
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