Left Bundle Branch Area Pacing and Atrioventricular Node Ablation in a Single-Procedure Approach for Elderly Patients with Symptomatic Atrial Fibrillation
Background: Implantation of a permanent pacemaker and atrioventricular (AV) node ablation (pace-and-ablate) is an established approach for rate and symptom control in elderly patients with symptomatic atrial fibrillation (AF). Left bundle branch area pacing (LBBAP) is a physiological pacing strategy...
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MDPI AG
2023-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/12/4028 |
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| author | Jesse H. J. Rijks Theo Lankveld Randolph Manusama Bernard Broers Antonius M. W. van Stipdonk Sevasti Maria Chaldoupi Rachel M. A. ter Bekke Ulrich Schotten Dominik Linz Justin G. L. M. Luermans Kevin Vernooy |
| author_facet | Jesse H. J. Rijks Theo Lankveld Randolph Manusama Bernard Broers Antonius M. W. van Stipdonk Sevasti Maria Chaldoupi Rachel M. A. ter Bekke Ulrich Schotten Dominik Linz Justin G. L. M. Luermans Kevin Vernooy |
| author_sort | Jesse H. J. Rijks |
| collection | DOAJ |
| description | Background: Implantation of a permanent pacemaker and atrioventricular (AV) node ablation (pace-and-ablate) is an established approach for rate and symptom control in elderly patients with symptomatic atrial fibrillation (AF). Left bundle branch area pacing (LBBAP) is a physiological pacing strategy that might overcome right ventricular pacing-induced dyssynchrony. In this study, the feasibility and safety of performing LBBAP and AV node ablation in a single procedure in the elderly was investigated. Methods: Consecutive patients with symptomatic AF referred for pace-and-ablate underwent the treatment in a single procedure. Data on procedure-related complications and lead stability were collected at regular follow-up at one day, ten days and six weeks after the procedure and continued every six months thereafter. Results: 25 patients (mean age 79.2 ± 4.2 years) were included and underwent successful LBBAP. In 22 (88%) patients, AV node ablation and LBBAP were performed in the same procedure. AV node ablation was postponed in two patients due to lead-stability concerns and in one patient on their own request. No complications related to the single-procedure approach were observed with no lead-stability issues at follow-up. Conclusions: LBBAP combined with AV node ablation in a single procedure is feasible and safe in elderly patients with symptomatic AF. |
| first_indexed | 2024-03-11T02:18:25Z |
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| language | English |
| last_indexed | 2024-03-11T02:18:25Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-6ebfc1040b0448d6968a87dbcfa3a1b22023-11-18T10:59:59ZengMDPI AGJournal of Clinical Medicine2077-03832023-06-011212402810.3390/jcm12124028Left Bundle Branch Area Pacing and Atrioventricular Node Ablation in a Single-Procedure Approach for Elderly Patients with Symptomatic Atrial FibrillationJesse H. J. Rijks0Theo Lankveld1Randolph Manusama2Bernard Broers3Antonius M. W. van Stipdonk4Sevasti Maria Chaldoupi5Rachel M. A. ter Bekke6Ulrich Schotten7Dominik Linz8Justin G. L. M. Luermans9Kevin Vernooy10Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The NetherlandsDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The NetherlandsDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The NetherlandsDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The NetherlandsDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The NetherlandsDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The NetherlandsDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The NetherlandsDepartment of Physiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The NetherlandsDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The NetherlandsDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The NetherlandsDepartment of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre (MUMC+), 6229 HX Maastricht, The NetherlandsBackground: Implantation of a permanent pacemaker and atrioventricular (AV) node ablation (pace-and-ablate) is an established approach for rate and symptom control in elderly patients with symptomatic atrial fibrillation (AF). Left bundle branch area pacing (LBBAP) is a physiological pacing strategy that might overcome right ventricular pacing-induced dyssynchrony. In this study, the feasibility and safety of performing LBBAP and AV node ablation in a single procedure in the elderly was investigated. Methods: Consecutive patients with symptomatic AF referred for pace-and-ablate underwent the treatment in a single procedure. Data on procedure-related complications and lead stability were collected at regular follow-up at one day, ten days and six weeks after the procedure and continued every six months thereafter. Results: 25 patients (mean age 79.2 ± 4.2 years) were included and underwent successful LBBAP. In 22 (88%) patients, AV node ablation and LBBAP were performed in the same procedure. AV node ablation was postponed in two patients due to lead-stability concerns and in one patient on their own request. No complications related to the single-procedure approach were observed with no lead-stability issues at follow-up. Conclusions: LBBAP combined with AV node ablation in a single procedure is feasible and safe in elderly patients with symptomatic AF.https://www.mdpi.com/2077-0383/12/12/4028atrial fibrillationatrioventricular node ablationleft bundle branch area pacingconduction system pacingrate controlsymptom control |
| spellingShingle | Jesse H. J. Rijks Theo Lankveld Randolph Manusama Bernard Broers Antonius M. W. van Stipdonk Sevasti Maria Chaldoupi Rachel M. A. ter Bekke Ulrich Schotten Dominik Linz Justin G. L. M. Luermans Kevin Vernooy Left Bundle Branch Area Pacing and Atrioventricular Node Ablation in a Single-Procedure Approach for Elderly Patients with Symptomatic Atrial Fibrillation Journal of Clinical Medicine atrial fibrillation atrioventricular node ablation left bundle branch area pacing conduction system pacing rate control symptom control |
| title | Left Bundle Branch Area Pacing and Atrioventricular Node Ablation in a Single-Procedure Approach for Elderly Patients with Symptomatic Atrial Fibrillation |
| title_full | Left Bundle Branch Area Pacing and Atrioventricular Node Ablation in a Single-Procedure Approach for Elderly Patients with Symptomatic Atrial Fibrillation |
| title_fullStr | Left Bundle Branch Area Pacing and Atrioventricular Node Ablation in a Single-Procedure Approach for Elderly Patients with Symptomatic Atrial Fibrillation |
| title_full_unstemmed | Left Bundle Branch Area Pacing and Atrioventricular Node Ablation in a Single-Procedure Approach for Elderly Patients with Symptomatic Atrial Fibrillation |
| title_short | Left Bundle Branch Area Pacing and Atrioventricular Node Ablation in a Single-Procedure Approach for Elderly Patients with Symptomatic Atrial Fibrillation |
| title_sort | left bundle branch area pacing and atrioventricular node ablation in a single procedure approach for elderly patients with symptomatic atrial fibrillation |
| topic | atrial fibrillation atrioventricular node ablation left bundle branch area pacing conduction system pacing rate control symptom control |
| url | https://www.mdpi.com/2077-0383/12/12/4028 |
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