Pacing devices to treat bradycardia: current status and future perspectives

Biffi, Mauro; Capobianco, Claudio; Spadotto, Alberto; Bartoli, Lorenzo; Sorrentino, Sergio; Minguzzi, Alessandro; Piemontese, Giuseppe Pio; Angeletti, Andrea; Toniolo, Sebastiano; Statuto, Giovanni

doi:10.1080/17434440.2021.1866543

Cited by 17 publications

(21 citation statements)

References 100 publications

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“…Several single-arm studies have observed the improvement of echocardiographic measurement and the NYHA class after the implantation of HBP and AVAB, while high pulmonary artery systolic pressure, high serum creatine, and low LVEF have been identified as the risk factor of poor prognosis ( 32 , 33 ). But different from HBP, BVP cannot be considered as a physiological pacing mode in patients with a QRS duration <130 ms which might increase the intra- and inter-ventricular activation time in these patients ( 34 , 35 ). However, HBP can still provide physiological activation sequence in these patients with narrow QRS ( 35 ) and thereby deliver more effective ventricular resynchronization ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

“…But different from HBP, BVP cannot be considered as a physiological pacing mode in patients with a QRS duration <130 ms which might increase the intra- and inter-ventricular activation time in these patients ( 34 , 35 ). However, HBP can still provide physiological activation sequence in these patients with narrow QRS ( 35 ) and thereby deliver more effective ventricular resynchronization ( 36 ). And sequential HBP followed by left ventricular pacing can also provide improved electrical resynchronization compared with BVP ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

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Pacemaker and Atrioventricular Junction Ablation in Patients With Atrial Fibrillation—A Systematic Review of Systematic Review and Meta-Analysis

Zhang

Wang

Lou

et al. 2022

Front. Cardiovasc. Med.

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BackgroundCardiac resynchronization therapy (CRT) could be considered for heart failure (HF) patients with atrial fibrillation (AF) unless a potent ventricular capture strategy is conducted. However, the benefit of a pacemaker (PM; as part of CRT) in patients with AF and whether atrioventricular junction (or nodal) ablation (AVAB) can improve the prognosis of these patients compared with those treated medically to support ventricular capture are unclear.Methods and ResultsSystematic reviews and meta-analyses investigating the roles of PMs and AVAB in patients with AF were obtained in a search of the PubMed, Embase, and Medline databases and then analyzed with respect to the following outcomes: mortality, left ventricular ejection fraction, and clinical findings including the New York Heart Association class, 6-min walk distance (6MWD), quality of life as assessed in a specific questionnaire, and response to CRT. The quality of the included reviews was assessed using the Assessing the Methodological Quality of Systematic Reviews 2 tool, which includes 16 items. This study was finally based on 13 systematic reviews or meta-analyses. The results showed that patients with AF have higher all-cause mortality rates compared with patients with sinus rhythm and that AVAB can reduce all-cause mortality in patients with AF. Although the functional improvement was better in sinus rhythm than in patients with AF, in the latter, AVAB increased the 6MWD and reduced the CRT nonresponse rate in patients with AF.ConclusionAtrial fibrillation is associated with a higher all-cause mortality rate in patients with CRT implantation. AVAB, by increasing the 6MWD and survival, can improve the prognosis of these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pacemaker and Atrioventricular Junction Ablation in Patients With Atrial Fibrillation—A Systematic Review of Systematic Review and Meta-Analysis

Zhang

Wang

Lou

et al. 2022

Front. Cardiovasc. Med.

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“…While much is still to be understood about the biologic behavior of cardiac conduction tissue at long term, further studies are needed to enhance persistence of a stable HBP threshold and of conduction in the His‐Purkinje network at long term. New power sources enabling high‐output use for >15 years would certainly lift the constraints currently posed by unanticipated pacing threshold increase in the long term in this young population (Biffi et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

His Bundle pacing for congenital complete AV block: An attempt to fix a broken heart?

Piemontese¹,

Ziacchi²,

Statuto³

et al. 2022

Noninvasive Electrocardiol

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Congenital complete atrioventricular block (CCAVB) is usually due to failure of atrioventricular nodal conduction with preservation of the His‐Purkinje system. Most patients with CCAVB ultimately require pacemaker therapy to restore physiologic heart rates, dealing with the detrimental effects of chronic right ventricular (RV) pacing on cardiac structure and function. The ideal stimulation pattern aims to mimic the normal conduction to restore electromechanical coupling, preventing the harmful effects of lack of atrioventricular and inter‐intraventricular synchrony. This can be done through conduction system pacing. Using His bundle pacing (HBP) for cardiac resynchronization therapy in two complete congenital atrioventricular block patients, we have reported better exercise tolerance and echocardiographic improvements related to reversible left ventricular dysfunction that can be corrected by restoration of the normal activation pathway via the His‐Purkinje network.

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“…Cardiac implantable electronic devices (CIEDs) significantly reduce morbidity and mortality by improving cardiac symptoms with appropriate indications 1–3 . Due to the increasing incidence of cardiovascular disease and the proven beneficial effects of CIEDs, the number of patients with such devices is constantly increasing 4…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of different exercises in preventing cardiac implantable electronic device‐related shoulder impairment

Coşgun

Cosgun

2022

Pacing Clinical Electrophis

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Background: Shoulder impairment on the implant side is common after cardiac implantable electronic device (CIED) implantation. The aim of this study was to compare the efficacy and safety of the pendulum exercise (PE) and stretching and strengthening exercises (SSE) in preventing postimplantation shoulder impairment. Methods:This prospective, randomized study collected data from 89 patients, including 30 in a control group, 31 in a PE group, and 28 in an SSE group. Shoulder functions on the implant side were evaluated by grip strength (GS), range of motion (ROM), Visual Analog Scale (VAS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), and 36-Item Short-Form Survey (SF-36).Results: Shoulder median flexion and abduction ROM were significantly improved 2month postimplantation compared to two-week postimplantation in PE (156 ± 11 vs. 146 ± 10, p = .002; 147 ± 9 vs. 136 ± 9, p = .001, respectively) and SSE (158 ± 13 vs. 147 ± 11, p = .003; 149 ± 13 vs. 138 ± 9, p = .002, respectively) groups, but not in the control group. Two months after implantation, the two exercise groups showed no significant differences in any assessment. Compared with the PE and SSE groups, the control group had significantly lower GS (p = .012 and p = .002, respectively) and SF-36 physical component summary (p = .007 and p = .003, respectively) and significantly higher VAS (p = .003 and p = .001, respectively) and QuickDASH (p = .002 and p = .005, respectively) scores 2-month postimplantation.Conclusions: PE and SSE for the ipsilateral upper arm starting two-week after CIED implantation provided similar benefits in preserving shoulder girdle muscle strength, maintaining shoulder motion, relieving shoulder pain, preventing shoulder injury, and improving quality of life, without the risk of lead dislodgement.

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Pacing devices to treat bradycardia: current status and future perspectives

Cited by 17 publications

References 100 publications

Pacemaker and Atrioventricular Junction Ablation in Patients With Atrial Fibrillation—A Systematic Review of Systematic Review and Meta-Analysis

Pacemaker and Atrioventricular Junction Ablation in Patients With Atrial Fibrillation—A Systematic Review of Systematic Review and Meta-Analysis

His Bundle pacing for congenital complete AV block: An attempt to fix a broken heart?

Efficacy and safety of different exercises in preventing cardiac implantable electronic device‐related shoulder impairment

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