Impact of atrial septal pacing in left ventricular–only pacing in patients with a first-degree atrioventricular block: A case series

Murata, Yu; Ishibashi, Keiichiro; Yamagata, Kenichiro; Izumi, Chisato; Noguchi, Teruo; Kusano, Kengo

doi:10.1016/j.hrcr.2021.12.003

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…RA septal pacing has been shown to result in a shorter AV interval than RAA pacing. 7 This result was highlighted in a case report in which sLVP rates were increased by RA septal pacing in patients with extremely prolonged PR intervals (424 ms). Consistent with our findings, some patients with RA septal pacing, especially those with prolonged PR intervals, had higher sLVP rates.…”

Section: Discussionmentioning

confidence: 91%

“…Compared with biventricular pacing, sLVP is associated with lower risks of heart failure, hospitalization, cardiac death, and atrial fibrillation; 5 , 6 however, achieving a high sLVP rate is difficult in some patients, especially those with prolonged PR intervals. 5 Although a case series has demonstrated that the sLVP rate was increased by right atrial (RA) septal pacing in patients with prolonged PR intervals, 7 to what extent RA septal pacing actually affects sLVP remains unknown. Therefore, this study aimed to identify the effective lead positions in the right atrium to secure a high sLVP rate.…”

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confidence: 99%

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Right Atrial Septal Lead Enhances the Favorable Effects of the Adaptive Cardiac Resynchronization Therapy Algorithm

Miyazaki,

Ishibashi,

Ueda

et al. 2024

JACC: Asia

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Section: Discussionmentioning

confidence: 91%

mentioning

confidence: 99%

Right Atrial Septal Lead Enhances the Favorable Effects of the Adaptive Cardiac Resynchronization Therapy Algorithm

Miyazaki,

Ishibashi,

Ueda

et al. 2024

JACC: Asia

Self Cite

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“…Prolonged PR intervals are considered a significant factor in preventing a high sLVP rate. A previous report showed that RA septal pacing was associated with a shorter AV interval than right appendage pacing (12). The case report demonstrated that the sLVP rate was increased by RA septal pacing in patients with extremely prolonged PR intervals (424 ms).…”

Section: Discussionmentioning

confidence: 99%

Impact of Synchronized Left Ventricular Pacing in Cardiac Resynchronization Therapy

Miyazaki

Ishibashi

Ueda

et al. 2023

Preprint

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BackgroundThe adaptive cardiac resynchronization therapy (aCRT) algorithm enables synchronized left ventricular pacing (sLVP) to produce fusion with intrinsic right ventricular activation in normal atrioventricular (AV) conduction. Although sLVP presents benefits over biventricular pacing (BVP), the adequate sLVP rate for better clinical outcomes remains unclear. This study aimed to assess the association between sLVP rates and clinical outcomes.MethodsAmong our cohort of 271 consecutive patients who underwent CRT implantation between April 2016 and August 2021, we evaluated 63 patients who underwent CRT without considerably prolonged AV conduction and applied the aCRT algorithm (48 men, mean age: 64 ± 14 years; median follow-up period: 316 days [interquartile range: 212–809 days]).ResultsAt the 6-month follow-up after CRT implantation, the frequency of CRT responders was 71% (n = 45). The sLVP rate was significantly higher in responders than in non-responders (75 ± 30 vs. 47 ± 40 %,p= 0.003). Receiver operating characteristics (ROC) curve analysis revealed that the optimal cut-off value during the sLVP rate was 59.4% for prediction of CRT responders (area under the curve, 0.70; sensitivity, 80%; specificity, 61%; positive predictive value, 84%; and negative predictive value, 55%). Kaplan–Meier analysis demonstrated that the higher sLVP group (sLVP ≥59.4%, n = 43) had better prognosis (cardiac death and heart failure hospitalization) than the lower sLVP group (sLVP <59.4%, n = 20) (log-rankp<0.001), and multivariate Cox hazard analysis revealed that a higher sLVP rate was associated with good prognosis (p<0.001).ConclusionsLVP was associated with CRT response, and higher sLVP rate (≥59.4%) is important for good prognosis in patients with aCRT.CLINICAL PERSPECTIVEWhat Is New?Synchronized left ventricular pacing(sLVP) >59.4% was a significant predictor of cardiac resynchronization therapy(CRT) responders and better clinical outcomes, evidenced by the results of the multivariate analysis.In this study, which included patients with moderately prolonged PR intervals, high sLVP rates were associated with better clinical outcomes.What Are the Clinical Implications?sLVP rate was associated with the improvement of cardiac function after CRT implantation.A higher sLVP rate was associated with a lower risk of cardiac death and heart failure hospitalization.

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Evaluation of synchronized left ventricular pacing rate over biventricular pacing in cardiac resynchronization therapy

Miyazaki,

Ishibashi,

Ueda

et al. 2024

Journal of Cardiology

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Impact of atrial septal pacing in left ventricular–only pacing in patients with a first-degree atrioventricular block: A case series

Cited by 3 publications

References 13 publications

Right Atrial Septal Lead Enhances the Favorable Effects of the Adaptive Cardiac Resynchronization Therapy Algorithm

Right Atrial Septal Lead Enhances the Favorable Effects of the Adaptive Cardiac Resynchronization Therapy Algorithm

Impact of Synchronized Left Ventricular Pacing in Cardiac Resynchronization Therapy

Evaluation of synchronized left ventricular pacing rate over biventricular pacing in cardiac resynchronization therapy

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