Cargando…

The role of conduction system pacing in patients with atrial fibrillation

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Wijesuriya, Nadeev, Mehta, Vishal, De Vere, Felicity, Strocchi, Marina, Behar, Jonathan M., Niederer, Steven A., Rinaldi, Christopher A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10248047/
https://www.ncbi.nlm.nih.gov/pubmed/37304966
http://dx.doi.org/10.3389/fcvm.2023.1187754
_version_ 1785055286140076032
author Wijesuriya, Nadeev
Mehta, Vishal
De Vere, Felicity
Strocchi, Marina
Behar, Jonathan M.
Niederer, Steven A.
Rinaldi, Christopher A.
author_facet Wijesuriya, Nadeev
Mehta, Vishal
De Vere, Felicity
Strocchi, Marina
Behar, Jonathan M.
Niederer, Steven A.
Rinaldi, Christopher A.
author_sort Wijesuriya, Nadeev
collection PubMed
description 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.
format Online
Article
Text
id pubmed-10248047
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-102480472023-06-09 The role of conduction system pacing in patients with atrial fibrillation Wijesuriya, Nadeev Mehta, Vishal De Vere, Felicity Strocchi, Marina Behar, Jonathan M. Niederer, Steven A. Rinaldi, Christopher A. Front Cardiovasc Med Cardiovascular Medicine 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. Frontiers Media S.A. 2023-05-25 /pmc/articles/PMC10248047/ /pubmed/37304966 http://dx.doi.org/10.3389/fcvm.2023.1187754 Text en © 2023 Wijesuriya, Mehta, De Vere, Strocchi, Behar, Niederer and Rinaldi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Wijesuriya, Nadeev
Mehta, Vishal
De Vere, Felicity
Strocchi, Marina
Behar, Jonathan M.
Niederer, Steven A.
Rinaldi, Christopher A.
The role of conduction system pacing in patients with atrial fibrillation
title The role of conduction system pacing in patients with atrial fibrillation
title_full The role of conduction system pacing in patients with atrial fibrillation
title_fullStr The role of conduction system pacing in patients with atrial fibrillation
title_full_unstemmed The role of conduction system pacing in patients with atrial fibrillation
title_short The role of conduction system pacing in patients with atrial fibrillation
title_sort role of conduction system pacing in patients with atrial fibrillation
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10248047/
https://www.ncbi.nlm.nih.gov/pubmed/37304966
http://dx.doi.org/10.3389/fcvm.2023.1187754
work_keys_str_mv AT wijesuriyanadeev theroleofconductionsystempacinginpatientswithatrialfibrillation
AT mehtavishal theroleofconductionsystempacinginpatientswithatrialfibrillation
AT deverefelicity theroleofconductionsystempacinginpatientswithatrialfibrillation
AT strocchimarina theroleofconductionsystempacinginpatientswithatrialfibrillation
AT beharjonathanm theroleofconductionsystempacinginpatientswithatrialfibrillation
AT niedererstevena theroleofconductionsystempacinginpatientswithatrialfibrillation
AT rinaldichristophera theroleofconductionsystempacinginpatientswithatrialfibrillation
AT wijesuriyanadeev roleofconductionsystempacinginpatientswithatrialfibrillation
AT mehtavishal roleofconductionsystempacinginpatientswithatrialfibrillation
AT deverefelicity roleofconductionsystempacinginpatientswithatrialfibrillation
AT strocchimarina roleofconductionsystempacinginpatientswithatrialfibrillation
AT beharjonathanm roleofconductionsystempacinginpatientswithatrialfibrillation
AT niedererstevena roleofconductionsystempacinginpatientswithatrialfibrillation
AT rinaldichristophera roleofconductionsystempacinginpatientswithatrialfibrillation