التفاصيل البيبلوغرافية
| العنوان: |
Prognostic benefits of His‐Purkinje capture in physiological pacemakers for bradycardia. |
| المؤلفون: |
Tan, Eugene S. J., Soh, Rodney, Lee, Jie‐Ying, Boey, Elaine, Chan, Siew‐Pang, Lim, Toon Wei, Yeo, Wee Tiong, Leong, Kevin M. W., Seow, Swee‐Chong, Kojodjojo, Pipin |
| المصدر: |
Journal of Cardiovascular Electrophysiology; Apr2024, Vol. 35 Issue 4, p727-736, 10p |
| مصطلحات موضوعية: |
ACADEMIC medical centers, CREATININE, HOSPITAL care, KRUSKAL-Wallis Test, TREATMENT effectiveness, HEART failure, DESCRIPTIVE statistics, CHI-squared test, MANN Whitney U Test, BRADYCARDIA, LONGITUDINAL method, ELECTROCARDIOGRAPHY, KAPLAN-Meier estimator, HIS bundle, PURKINJE fibers, RESEARCH, STATISTICS, RIGHT heart ventricle, CARDIAC pacemakers, HEART block, CONFIDENCE intervals, COMPARATIVE studies, DATA analysis software, VENTRICULAR septum, PROPORTIONAL hazards models |
| مصطلحات جغرافية: |
SINGAPORE |
| مستخلص: |
Introduction: Clinical outcomes of long‐term ventricular septal pacing (VSP) without His‐Purkinje capture remain unknown. This study evaluated the differences in clinical outcomes between conduction system pacing (CSP), VSP, and right ventricular pacing (RVP). Methods: Consecutive patients with bradycardia indicated for pacing from 2016 to 2022 were prospectively followed for the clinical endpoints of heart failure (HF)‐hospitalizations and all‐cause mortality at 2 years. VSP was defined as septal pacing due to unsuccessful CSP implant or successful CSP followed by loss of His‐Purkinje capture within 90 days. Results: Among 1016 patients (age 73.9 ± 11.2 years, 47% female, 48% atrioventricular block), 612 received RVP, 335 received CSP and 69 received VSP. Paced QRS duration was similar between VSP and RVP, but both significantly longer than CSP (p <.05). HF‐hospitalizations occurred in 130 (13%) patients (CSP 7% vs. RVP 16% vs. VSP 13%, p =.001), and all‐cause mortality in 143 (14%) patients (CSP 7% vs. RVP 19% vs. VSP 9%, p <.001). The association of pacing modality with clinical events was limited to those with ventricular pacing (Vp) > 20% (pinteraction <.05). Adjusting for clinical risk factors among patients with Vp > 20%, VSP (adjusted hazard ratio [AHR]: 4.74, 95% confidence interval [CI]: 1.57–14.36) and RVP (AHR: 3.08, 95% CI: 1.44‐6.60) were associated with increased hazard of HF‐hospitalizations, and RVP (2.52, 95% CI: 1.19–5.35) with increased mortality, compared to CSP. Clinical endpoints did not differ between VSP and RVP with Vp > 20%, or amongst groups with Vp < 20%. Conclusion: Conduction system capture is associated with improved clinical outcomes. CSP should be preferred over VSP or RVP during pacing for bradycardia. [ABSTRACT FROM AUTHOR] |
|
Copyright of Journal of Cardiovascular Electrophysiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
