Affiliation:
1. Division of Cardiology Department of Medicine Rush University Medical Center Chicago IL
2. Division of Cardiology Department of Medicine Geisinger Heart Institute Wilkes‐Barre PA
3. Division of Cardiology Department of Medicine John H Stroger Jr Hospital of Cook County Chicago IL
Abstract
Background
Conventional right ventricular pacing (RVP) has been associated with an increased incidence of atrial fibrillation (AF). We sought to compare the occurrence of new‐onset AF and assessed AF disease progression during long‐term follow‐up between His bundle pacing (HBP) and RVP.
Methods and Results
We included patients undergoing initial dual‐chamber pacemaker implants at Rush University Medical Center between January 1, 2016, and June 30, 2019. A total of 360 patients were evaluated, and 225 patients (HBP, n=105; RVP, n=120) were included in the study. Among the 148 patients (HBP, n=72; RVP, n=76) with no history of AF, HBP demonstrated a lower risk of new‐onset AF (adjusted hazard ratio [HR], 0.53; 95% CI, 0.28–0.99;
P
=0.046) compared with traditional RVP. This benefit was observed with His or RVP burden exceeding 20% (HR, 0.29; 95% CI, 0.13–0.64;
P
=0.002), ≥40% (HR, 0.31;
P
=0.007), ≥60% (HR, 0.35;
P
=0.015), and ≥80% (HR, 0.40;
P
=0.038). There was no difference with His or RV pacing burden <20% (HR, 0.613; 95% CI, 0.213–1.864;
P
=0.404). In patients with a prior history of AF, there was no difference in AF progression (
P
=0.715); however, in a subgroup of patients with a pacing burden ≥40%, HBP demonstrated a trend toward a lower risk of AF progression (HR, 0.19; 95% CI, 0.03–1.16;
P
=0.072).
Conclusions
HBP demonstrated a lower risk of new‐onset AF compared with RVP, which was primarily observed at a higher pacing burden.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
24 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献