Key result
His bundle pacing and atrioventricular node ablation guided by 3-D mapping was successfully achieved in 17 of 18 patients (94.4%) with a mean procedure duration of 99.4 minutes.
Why the study?
The feasibility and efficiency of His bundle pacing and AVN ablation guided throughout the procedure by a 3-D mapping system needed assessment.
Is His bundle pacing and atrioventricular node ablation guided by a three-dimensional mapping system feasible and efficient in patients with refractory permanent atrial fibrillation?
Observational (n=18)
Is His bundle pacing and atrioventricular node ablation guided by a three-dimensional mapping system feasible and efficient in patients with refractory permanent atrial fibrillation?
A 3-D mapping system can feasibly and efficiently guide His bundle pacing and AVN ablation, resulting in low fluoroscopy times.
Supports feasibility of 3-D–guided His pacing with AVN ablation in refractory AF; hypothesis-generating and requires prospective validation.
BACKGROUND: Atrioventricular node (AVN) ablation combined with His bundle pacing is an effective strategy for permanent atrial fibrillation (AF) with rapid ventricular rate refractory to pharmacological therapy. We aimed to access the feasibility and efficiency of His bundle pacing and AVN ablation guided by three-dimensional (3-D) mapping system throughout the procedure. METHODS: Eighteen patients with permanent AF with refractory rate and symptoms were referred for His bundle pacing and AVN ablation guided by 3-D mapping (CARTO3). Electroanatomic 3-D mapping of the right atrium and right ventricle was performed by the ablation catheter with CARTO 3 system, followed by the visualization of the leads for implantation and AVN ablation. RESULTS: Implantation of His bundle and ventricular leads and AVN ablation were achieved successfully with the help of 3-D mapping in 17 patients. Selective His bundle pacing was achieved in five patients (29.4%), and the other (70.6%) were nonselective His bundle pacing. The mean procedure duration was 99.4 ± 16.4 minutes. The mean fluoroscopy time was 7.0 ± 2.6 minutes. The time spent on His lead implantation was 6.1 ± 3.2 minutes. One patient experienced AVN ablation from left side under aortic valves due to no effect of ablation in right atrium. CONCLUSION: His bundle pacing and AVN ablation guided by throughout real-time 3-D mapping system are of high-efficiency and feasibility.
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Sun et al. (2020) conducted an observational in Permanent atrial fibrillation (n=18). His bundle pacing and atrioventricular node ablation guided by 3-D mapping was evaluated on Feasibility and efficiency (successful implantation and ablation). His bundle pacing and atrioventricular node ablation guided by 3-D mapping was successfully achieved in 17 of 18 patients (94.4%) with a mean procedure duration of 99.4 minutes.
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