Direct-current shock His bundle ablation significantly reduced global left ventricular ejection fraction at 3 months compared to pre-ablation baseline (0.43 vs 0.50, p=0.02).
Observational (n=14)
Absolute Event Rate: 0.43% vs 0.5%
p-value: p=0.02
Catheter-induced His bundle ablation for refractory supraventricular arrhythmias is most commonly performed with direct-current shock energy of 200-300 joules. The high energy pulse delivered by direct-current shock produces a lesion in the atrioventricular node by fulguration, with the residual energy being dissipated as a pressure wave. The effect of direct-current shock His bundle ablation on global and regional ventricular function was assessed in 14 consecutive patients by radionuclide ventriculography performed before and after ablation and again three months later. All studies were performed with ventricular pacing at 110 bpm. Global left ventricular ejection fraction was found to be significantly reduced at the three month study (0.43 +/- 0.03 vs 0.50 +/- 0.03, pre ablation, p = 0.02). A significant reduction in wall-motion score was also seen in six of the seven patients who had normal wall motion in pacing rhythm prior to ablation. Deterioration was mainly seen at the left and right ventricular apices. The observed reduction in ventricular function that follows direct-current shock His bundle ablation may result from myocardial damage from electro-coagulation or from barotrauma and supports continued investigation into alternative, less traumatic energy sources for the procedure.
Warren et al. (Fri,) conducted a observational in refractory supraventricular arrhythmias (n=14). Direct-current shock His bundle ablation vs. Pre-ablation baseline was evaluated on Global left ventricular ejection fraction (p=0.02). Direct-current shock His bundle ablation significantly reduced global left ventricular ejection fraction at 3 months compared to pre-ablation baseline (0.43 vs 0.50, p=0.02).