His-bundle pacing vs biventricular pacing following atrioventricular nodal ablation in patients with atrial fibrillation and reduced ejection fraction: A multicenter, randomized, crossover study—The ALTERNATIVE-AF trial

Huang, Weijian; Wang, Songjie; Su, Lan; Fu, Guosheng; Su, Yangang; Chen, Keping; Zou, Jiangang; Han, Hua; Wu, Shengjie; Sheng, Xia; Chen, Xueying; Fan, Xiaohan; Xu, Lei; Zhou, Xiaohong; Mao, Guangyun; Ellenbogen, Kenneth A.; Whinnett, Zachary I.

doi:10.1016/j.hrthm.2022.07.009

Cited by 50 publications

(44 citation statements)

References 27 publications

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“…Therefore, it could represent an alternative to BiV pacing in patients with an expected high percentage of pacing with concomitant severe left ventricular dysfunction and narrow QRS (3,7). Recent randomized trials further confirmed that HBP could deliver better improvement of EF compared to BiV in patients undergoing AVNA (8). However, there are some limitations associated with HBP, e.g.…”

Section: Discussionmentioning

confidence: 99%

Case report: Treatment of tachycardia-induced cardiogenic shock with permanent His bundle pacing and atrioventricular node ablation

Žlahtič

Fister²,

Radšel³

et al. 2022

Front. Cardiovasc. Med.

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Tachycardia-induced cardiomyopathy (T-CMP) related to supraventricular arrhythmia is a rare and often unrecognized cause of refractory cardiogenic shock. When rhythm control interventions are ineffective or no longer pursued, atrioventricular node ablation (AVNA) with pacemaker implantation is indicated. Conduction system pacing provides normal synchronous activation of the ventricles after AVNA. However, there is a lack of data on pace and ablate strategy in hemodynamically unstable patients. We report on 2 patients with T-CMP presenting with refractory cardiogenic shock who were successfully treated with His bundle pacing in conjunction with AVNA.

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Section: Discussionmentioning

confidence: 99%

Case report: Treatment of tachycardia-induced cardiogenic shock with permanent His bundle pacing and atrioventricular node ablation

Žlahtič

Fister²,

Radšel³

et al. 2022

Front. Cardiovasc. Med.

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“…Preliminary studies showed that AVJA is technically feasible in the presence of a CSP lead, portending significant improvement in QRS duration, LVEF, and better clinical outcomes (reduction of death and HF hospitalizations) compared with RVP and BVP (Vijayaraman et al, 2022d). Recently, in a multicenter, prospective, randomized crossover trial, enrolling 50 patients undergoing AVJA, HBP delivered a modest but significant improvement in LVEF in patients with persistent AF, impaired left ventricular function (LVEF≤40%), and narrow QRS duration, compared with BVP (Huang et al, 2022). Noteworthy, in an observational study, AVJA in the presence of an LBBAP lead was associated with a higher success rate and fewer acute and chronic lead-related complications compared to AVJA in the presence of an HBP lead (Pillai et al, 2022).…”

Section: Pace and Ablatementioning

confidence: 99%

Conduction system pacing for cardiac resynchronization therapy: State of the art, current controversies, and future perspectives

et al. 2023

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Biventricular pacing (BVP) is the established treatment to perform cardiac resynchronization therapy (CRT) in patients with heart failure (HF) and left bundle branch block (LBBB). However, BVP is an unnatural pacing modality still conditioned by the high percentage of non-responders and coronary sinus anatomy. Conduction system pacing (CSP)—His bundle pacing (HBP) and Left bundle branch area pacing (LBBAP)- upcomes as the physiological alternative to BVP in the quest for the optimal CRT. CSP showed promising results in terms of better electro-mechanical ventricular synchronization compared to BVP. However, only a few randomized control trials are currently available, and technical challenges, along with the lack of information on long-term clinical outcomes, limit the establishment of a primary role for CSP over conventional BVP in CRT candidates. This review provides a comprehensive literature revision of potential applications of CSP for CRT in diverse clinical scenarios, underlining the current controversies and prospects of this technique.

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“…Previous studies and guidelines suggest that in patients with reduced LVEF and narrow QRS complex, BVP provides limited benefit ( Moss et al, 2009 ; Tracy et al, 2012 ). Compelling results of applying CSP in patients with PICM, RV pacing upgrading as well as AV node ablation in atrial fibrillation patients are accumulating ( Vijayaraman et al, 2017 ; Cai et al, 2022 ; Huang W. et al, 2022 ; Ivanovski et al, 2022 ). Hence, we expect that CSP may be a better option for primary and upgrading therapy in HF patients who have intact intraventricular conduction but need high RV pacing burden due to bradycardia or AV node ablation.…”

Section: Conduction System Pacing: the Evidence For Clinical Efficacymentioning

confidence: 99%

Recruitment of the cardiac conduction system for optimal resynchronization therapy in failing heart

Chen

Zhou

et al. 2022

Front. Physiol.

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His-bundle pacing vs biventricular pacing following atrioventricular nodal ablation in patients with atrial fibrillation and reduced ejection fraction: A multicenter, randomized, crossover study—The ALTERNATIVE-AF trial

Cited by 50 publications

References 27 publications

Case report: Treatment of tachycardia-induced cardiogenic shock with permanent His bundle pacing and atrioventricular node ablation

Case report: Treatment of tachycardia-induced cardiogenic shock with permanent His bundle pacing and atrioventricular node ablation

Conduction system pacing for cardiac resynchronization therapy: State of the art, current controversies, and future perspectives

Recruitment of the cardiac conduction system for optimal resynchronization therapy in failing heart

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