His-Purkinje conduction system pacing combined with atriove-ntricular node ablation improves quality of life in older patients with persistent atrial fibrillation refractory to multiple ablation procedures
Peng QI1
Yi-Zhen YANG2
Liang SHI2
Yan-Jiang WANG2
Ying TIAN2
Ke-Xin YUAN3
Xue-Feng CHEN3
Shu-Ren LI3
Yi DANG3
Xing-Peng LIU2
1.Heart Center,Beijing Chaoyang Hospital,Capital Medical University,Beijing,China;Heart Center,Hebei General Hospital,Hebei,China2.Heart Center,Beijing Chaoyang Hospital,Capital Medical University,Beijing,China3.Heart Center,Hebei General Hospital,Hebei,China
摘要：BACKGROUND Recurrence of atrial fibrillation (AF) is common in patients with persistent AF even after multiple ablation pro-cedures. His-Purkinje conduction system pacing (HPCSP) combined with atrioventricular node ablation (AVNA) is effective in ma-naging patients with AF and heart failure. This study aimed to determine whether HPCSP combined with AVNA can improve qua-lity of life and alleviate symptoms in older patients with symptomatic persistent AF refractory to multiple ablation procedures, as well as evaluate the feasibility and safety of this therapy. METHODS Older patients (≥ 65 years) with symptomatic persistent AF refractory to at least two ablation procedures were trea-ted with combined HPCSP and AVNA. The success rates and complications were recorded. Pacing parameters, European Heart Rh-ythm Association (EHRA) scores, and Atrial Fibrillation Effect on Quality-of-Life (AFEQT) scores obtained perioperatively were co-mpared with those recorded at the 6-month follow-up examination. RESULTS Thirty-one patients were enrolled; of those, only thirty patients were eventually treated with AVNA because one pa-tient developed a complete atrioventricular block following the withdrawal of the His bundle pacing lead. The success rates were 100％ for HPCSP (22 cases with His bundle pacing, and 9 cases with left bundle branch pacing) and 93.3％ (28/30) for AVNA, re-spectively. By the 6-month follow-up examination, EHRA scores improved significantly (3.00 ± 0.73 vs. 2.44 ± 0.63, P = 0.014) and AFEQT scores increased markedly (49.6 ± 20.6 vs. 70.9 ± 14.0, P = 0.001). No severe complications developed. CONCLUSIONS When used in older patients with symptomatic persistent AF refractory to multiple ablation procedures, HPC-SP combined with AVNA significantly alleviated symptoms and improved quality of life during short-term follow-up. This thera-py was proved to be safe and effective in this patient population.
机标关键词：qualitysystemwithlifenodeablationatrialatriove
论文发表日期：2023-02-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 130-138 )