The risk of atrial fibrillation during right ventricular pacing

Pastore, Gianni; Zanon, Francesco; Baracca, Enrico; Aggio, Silvio; Corbucci, Giorgio; Boaretto, Graziano; Roncon, Loris; Noventa, Franco; Barold, S. Serge

doi:10.1093/europace/euv268

Cited by 68 publications

(80 citation statements)

References 19 publications

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“…40 Of note, a retrospective study involving 477 consecutive patients who underwent PPM implantation for complete or advanced AVB demonstrated that RV pacing in the Hisian area compared with RV pacing in apical and septal positions was associated with lower risk of persistent / permanent AF after mean follow -up of nearly 5 years. 38 Importantly, the reported risk of chronic AF development was similar in both apical and septal RV pacing groups with the rate of progression at 25.7% and 28%, respectively. 38 In keeping with these findings, we found that the risk of permanent AF development was similar between patients with apical and nonapical RV lead position.…”

Section: Figure 3 Association Of Baseline Factors With Permanent Atrimentioning

confidence: 85%

“…38 Importantly, the reported risk of chronic AF development was similar in both apical and septal RV pacing groups with the rate of progression at 25.7% and 28%, respectively. 38 In keeping with these findings, we found that the risk of permanent AF development was similar between patients with apical and nonapical RV lead position. Moreover, the analysis in patients who had a DDD PPM implanted during the last decade of the inclusion period showed similar results.…”

Section: Figure 3 Association Of Baseline Factors With Permanent Atrimentioning

confidence: 85%

“…Age was demonstrated as independent factor for AF and chronic permanent AF in numerous previous studies. 5,8,22,25,29,31,[35][36][37][38] The odds ratio of AF for each decade of advancing age was 2.1 for men and 2.2 for women. 22 In our population, patients with a history of AF had more frequently SSS compared with AVB.…”

Section: Figure 3 Association Of Baseline Factors With Permanent Atrimentioning

confidence: 99%

“…In accordance with our findings, history of AF before pacemaker implantation was the strongest independent predictor of postimplant AF in both prospective 17 and retrospective studies. 25,26,37,38 To our knowledge, no randomized large -scale clinical studies have demonstrated so far a more deleterious clinical long -term effect of the RV apical pacing compared with septal pacing in bradycardia pacemaker recipients with normal baseline left ventricular function. A randomized trial comparing sustained apical RV pacing with septal pacing in patients with high--grade AVB failed to demonstrate any difference in AF burden over a 2-year study period.…”

Section: Figure 3 Association Of Baseline Factors With Permanent Atrimentioning

confidence: 99%

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Permanent atrial fibrillation in patients with a dual‑chamber pacemaker

Dębski¹,

Ulman²,

Ząbek³

et al. 2019

Kardiol Pol

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BACKGROUND Atrial fibrillation (AF) is thought to be a progressive arrhythmia. The impact of sex and position of right ventricular lead is not well recognized. Whilst nonparoxysmal AF compared with paroxysmal AF has been associated with increased mortality in the general population, its prognostic significance in patients with a dual -chamber (DDD) pacemaker is less clear. AIMS The aim of the study was to determine the incidence of permanent AF in patients with a DDD pacemaker, analyze the effect of selected baseline characteristics on permanent AF development, and examine the impact of permanent AF on patient survival. METHODS A retrospective cohort study included 3932 consecutive patients who underwent DDD pacing system implantation between 1984 and 2014. Follow -up was completed in August 2016. We included 3771 patients (96%) with post -operative follow -up and known vital status. Occurrence of permanent AF and all -cause mortality were the study endpoints. RESULTS During mean follow -up of 6.5 years, permanent AF occurred in 717 patients (19%). Sex (hazard ratio [HR], 1.316; 95% CI, 1.134-1.528, for men), age at implant (HR, 1.041; 95% CI, 1.033-1.049, 1-year increase), history of AF (HR, 3.521; 95% CI, 3.002-4.128) were independently associated with permanent AF development, whereas position of right ventricular lead (apical versus nonapical) and primary pacing indication (atrioventricular block versus sick sinus syndrome) were not related to permanent AF. Permanent AF was a significant risk factor for increased mortality (age-and sex -adjusted HR, 1.475; 95% CI, 1.294-1.682). CONCLUSIONS Permanent AF occurrence was independently predicted by advanced age at implant, male sex, and preexisting AF and associated with worse survival.

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Section: Figure 3 Association Of Baseline Factors With Permanent Atrimentioning

confidence: 85%

Section: Figure 3 Association Of Baseline Factors With Permanent Atrimentioning

confidence: 85%

Section: Figure 3 Association Of Baseline Factors With Permanent Atrimentioning

confidence: 99%

Section: Figure 3 Association Of Baseline Factors With Permanent Atrimentioning

confidence: 99%

See 2 more Smart Citations

Permanent atrial fibrillation in patients with a dual‑chamber pacemaker

Dębski¹,

Ulman²,

Ząbek³

et al. 2019

Kardiol Pol

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“…A disadvantage of AV dyssynchrony encountered with this model-because of RV only pacing-is the potential for cardiac dysfunction and cardiomyopathy. There is a body of work that shows single chamber ventricular pacing and AVB can lead to increased risks of atrial fibrillation and decreased quality of life [17][18][19]. It is unknown what the longer-term effects of our model are and whether this could affect the outcomes of experiments assessed over a longer period of time.…”

Section: Discussionmentioning

confidence: 99%

Development of a sheep model of atrioventricular block for the application of novel therapies

Farraha

Trivic

et al. 2020

PLoS ONE

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Evaluation of electrophysiological characteristics and ventricular synchrony: An intrapatient‐controlled study during His‐Purkinje conduction system pacing versus right ventricular pacing

Chen

Zhou

Wang

et al. 2022

Clinical Cardiology

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Objectives to Background To compare electromechanical ventricular synchrony when pacing from different sites, including right ventricular apex pacing (RVAP), right ventricular septum pacing (RVSP), His bundle pacing (HBP), left bundle branch pacing (LBBP), and RVSP during unipolar pacing from the ring electrode of LBBP lead (RVSP ring ) in each patient and evaluate the correlations between electrophysiological characteristics and ventricular synchrony. Methods Twenty patients with complete atrioventricular block indicated for dual‐chamber pacemaker implantation were included in the study. Unipolar pacing at different sites, including RVAP, RVSP, HBP, LBBP, and RVSP ring , was successively performed in each patient. The pacing characteristics and echocardiogram parameters were collected and compared among intrinsic rhythm and pacing at different sites. Results Similar to HBP (114.84 ± 18.67 ms), narrower paced QRSd was found in LBBP (116.15 ± 11.60 ms) as compared to RVSP ring (135.11 ± 13.68 ms), RVSP (141.65 ± 14.26 ms), and RVAP (160.15 ± 19.35 ms) ( p < .001). LBBP showed comparable pacing parameters to RVAP or RVSP and was significantly better than HBP, with maintained cardiac function. TS‐12‐SD was significantly improved in LBBP (41.80 ± 20.97 ms) than RVAP (69.70 ± 32.42 ms, p = .003) and RVSP (63.30.56 ± 32.53 ms, p = .018) but similar to HBP (51.50 ± 25.67 ms, p = .283) or RVSP ring (57.80 ± 25.65 ms, p = .198). Among these pacing strategies, negative values of interventricular mechanical delay (IVMD) were only identified in LBBP (−19.25 ± 18.43 ms), significantly different from RVAP (35.00 ± 30.72 ms), RVSP (22.85 ± 22.05 ms), HBP (5.20 ± 18.64 ms), and RVSP ring (16.00 ± 26.76 ms (all p < .05). Using Pearson's analysis, Sti‐LVAT was positively correlated with QRS duration, IVMD, TS‐12‐SD, LVEDV, and LVESV, while a negative relationship could be observed for left ventricular ejection fraction. Conclusions His‐Purkinje conduction system pacing (HPCSP) achieved better electrical and mechanical synchrony than conventional RV pacing. For interventricular synchrony, only LBBP initiated earlier LV activation than RV, in accordance with the right bundle branch block (RBBB) pattern of paced QRS during LBBP. Sti‐LVAT might be a good parameter correlating with LV systolic function and mechanical synchrony.

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The risk of atrial fibrillation during right ventricular pacing

Abstract: HA pacing compared with RVA or RVS pacing seems to be associated with a lower risk of persistent/permanent AF occurrence. The risk of persistent/permanent AF was similar in the RVA vs. RVS groups.

Cited by 68 publications

References 19 publications

Permanent atrial fibrillation in patients with a dual‑chamber pacemaker

Permanent atrial fibrillation in patients with a dual‑chamber pacemaker

Development of a sheep model of atrioventricular block for the application of novel therapies

Evaluation of electrophysiological characteristics and ventricular synchrony: An intrapatient‐controlled study during His‐Purkinje conduction system pacing versus right ventricular pacing

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