Key result
Localization of the atrial electrode in the area of Bakhman's fascicles reduced the cumulative percent of ventricular stimulation compared to the right atrial auricle (4% vs 43% at 12 months).
Why the study?
Does permanent pacing with the atrial electrode in the area of Bakhman’s fascicles reduce the cumulative percent of ventricular stimulation compared to right atrial auricle pacing in patients with sinus node asthenia?
Cohort (n=74)
Does permanent pacing with the atrial electrode in the area of Bakhman’s fascicles reduce the cumulative percent of ventricular stimulation compared to right atrial auricle pacing in patients with sinus node asthenia?
Pacing in the area of Bakhman’s fascicles significantly reduces unnecessary right ventricular stimulation compared to traditional right atrial auricle pacing in patients with sinus node asthenia.
Alternative atrial lead placement may reduce ventricular stimulation in sinus node dysfunction; leaves open need for randomized confirmation before practice change.
This research includes 74 patients with syndrome of the sinus node asthenia. The application of permanent bilocular pacing was indicated for these patients. An atrial electrode was located in the right atrial auricle in 37 patients and it was in the area of Bakhman’s fascicles in other 37 patients. All the patients had a stimulated atrio-ventricular delay on 250 ms, but sensing delay was shorter on 20 ms. Given data were analyzed after operation in the periods of 6 and 12 months. Cumulative percent of ventricular stimulation was significantly less in the group with electrode in the area of Bakhman’s fascicles (6%) as compared with the group where electrode installed in the right atrial auricle (41%) after 6 months. There were 4% in comparison with 43% after 12 months. The localization of atrial electrode in the area of Bakhman’s fascicles led to reduction of cumulative percent of ventricular stimulation on 35% after 6 months and on 39% after 12 months. Permanent pacing in the area of Bakhman’s fascicles could be an effective mode to decrease the part of amotivational stimulation of the right ventricle.
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Didenko et al. (2016) conducted a cohort in Syndrome of the sinus node asthenia (n=74). Atrial electrode located in the area of Bakhman's fascicles vs. Atrial electrode located in the right atrial auricle was evaluated on Cumulative percent of ventricular stimulation at 12 months. Localization of the atrial electrode in the area of Bakhman's fascicles reduced the cumulative percent of ventricular stimulation compared to the right atrial auricle (4% vs 43% at 12 months).
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