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Laxina I, Narvaneni S, Kanjwal K. Confronting an entrenched atrioventricular node: Ablation strategies for an elusive target. HeartRhythm Case Rep 2023; 9:659-661. [PMID: 37746576 PMCID: PMC10511936 DOI: 10.1016/j.hrcr.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Affiliation(s)
- Ian Laxina
- Department of Cardiology, McLaren Greater Lansing, Michigan State University, Lansing, Michigan
| | - Spandana Narvaneni
- Department of Cardiology, McLaren Greater Lansing, Michigan State University, Lansing, Michigan
| | - Khalil Kanjwal
- Department of Cardiology, McLaren Greater Lansing, Michigan State University, Lansing, Michigan
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Wijesuriya N, Mehta V, De Vere F, Strocchi M, Behar JM, Niederer SA, Rinaldi CA. The role of conduction system pacing in patients with atrial fibrillation. Front Cardiovasc Med 2023; 10:1187754. [PMID: 37304966 PMCID: PMC10248047 DOI: 10.3389/fcvm.2023.1187754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 04/24/2023] [Indexed: 06/13/2023] Open
Abstract
Conduction system pacing (CSP) has emerged as a promising novel delivery method for Cardiac Resynchronisation Therapy (CRT), providing an alternative to conventional biventricular epicardial (BiV) pacing in indicated patients. Despite increasing popularity and widespread uptake, CSP has rarely been specifically examined in patients with atrial fibrillation (AF), a cohort which forms a significant proportion of the heart failure (HF) population. In this review, we first examine the mechanistic evidence for the importance of sinus rhythm (SR) in CSP by allowing adjustment of atrioventricular delays (AVD) to achieve the optimal electrical response, and thus, whether the efficacy of CSP may be significantly attenuated compared to conventional BiV pacing in the presence of AF. We next evaluate the largest clinical body of evidence in this field, related to patients receiving CSP following atrioventricular nodal ablation (AVNA) for AF. Finally, we discuss how future research may be designed to address the vital question of how effective CSP in AF patients is, and the potential hurdles we may face in delivering such studies.
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Affiliation(s)
- Nadeev Wijesuriya
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Cardiology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Vishal Mehta
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Cardiology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Felicity De Vere
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Cardiology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Marina Strocchi
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Jonathan M. Behar
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Cardiology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Steven A. Niederer
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Research and Innovation Cluster, Alan Turing Institute, London, United Kingdom
| | - Christopher A. Rinaldi
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Department of Cardiology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
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Mugnai G, Volpiana A, Cavedon S, Mecenero A, Ambroso D, Perrone C, Bilato C. The radiofrequency interference on CRT-D functioning during AV node ablation: An educational case. J Arrhythm 2020; 37:467-469. [PMID: 33850596 PMCID: PMC8021988 DOI: 10.1002/joa3.12467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/01/2020] [Accepted: 11/01/2020] [Indexed: 11/19/2022] Open
Affiliation(s)
- Giacomo Mugnai
- Division of Cardiology Arzignano Hospital Arzignano (Vicenza) Italy
| | - Andrea Volpiana
- Division of Cardiology Arzignano Hospital Arzignano (Vicenza) Italy
| | - Stefano Cavedon
- Division of Cardiology Arzignano Hospital Arzignano (Vicenza) Italy
| | | | | | - Cosimo Perrone
- Division of Cardiology Arzignano Hospital Arzignano (Vicenza) Italy
| | - Claudio Bilato
- Division of Cardiology Arzignano Hospital Arzignano (Vicenza) Italy
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