Bibliographic Details
| Title: |
Therapeutic potential of conduction system pacing as a method for improving cardiac output during ventricular tachycardia. |
| Authors: |
Keene, Daniel, Miyazawa, Alejandra A., Arnold, Ahran D., Naraen, Akriti, Kaza, Nandita, Mohal, Jagdeep S., Lefroy, David C., Lim, Phang Boon, Ng, Fu Siong, Koa-Wing, Michael, Qureshi, Norman A., Linton, Nick W. F., Wright, Ian, Peters, Nicholas S., Kanagaratnam, Prapa, Shun-Shin, Matthew J., Francis, Darrel P., Whinnett, Zachary I. |
| Source: |
Journal of Interventional Cardiac Electrophysiology; Oct2024, Vol. 67 Issue 7, p1603-1613, 11p |
| Abstract: |
Background: Ventricular tachycardia (VT) reduces cardiac output through high heart rates, loss of atrioventricular synchrony, and loss of ventricular synchrony. We studied the contribution of each mechanism and explored the potential therapeutic utility of His bundle pacing to improve cardiac output during VT. Methods: Study 1 aimed to improve the understanding of mechanisms of harm during VT (using pacing simulated VT). In 23 patients with left ventricular impairment, we recorded continuous ECG and beat-by-beat blood pressure measurements. We assessed the hemodynamic impact of heart rate and restoration of atrial and biventricular synchrony. Study 2 investigated novel pacing interventions during clinical VT by evaluating the hemodynamic effects of His bundle pacing at 5 bpm above the VT rate in 10 patients. Results: In Study 1, at progressively higher rates of simulated VT, systolic blood pressure declined: at rates of 125, 160, and 190 bpm, -22.2%, -42.0%, and -58.7%, respectively (ANOVA p < 0.0001). Restoring atrial synchrony alone had only a modest beneficial effect on systolic blood pressure (+ 3.6% at 160 bpm, p = 0.2117), restoring biventricular synchrony alone had a greater effect (+ 9.1% at 160 bpm, p = 0.242), and simultaneously restoring both significantly increased systolic blood pressure (+ 31.6% at 160 bpm, p = 0.0003). In Study 2, the mean rate of clinical VT was 143 ± 21 bpm. His bundle pacing increased systolic blood pressure by + 14.2% (p = 0.0023). In 6 of 10 patients, VT terminated with His bundle pacing. Conclusions: Restoring atrial and biventricular synchrony improved hemodynamic function in simulated and clinical VT. Conduction system pacing could improve VT tolerability and treatment. [ABSTRACT FROM AUTHOR] |
|
Copyright of Journal of Interventional Cardiac Electrophysiology is the property of Springer Nature 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.) |
| Database: |
Complementary Index |
