High efficiency and workflow of His bundle pacing and atrioventricular node ablation guided by three-dimensional...

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Atrioventricular node (AVN) ablation combined with His bundle pacing is effective for permanent atrial fibrillation (AF) with rapid ventricular rates unresponsive to drugs.
• This study evaluates the feasibility and efficiency of His bundle pacing and AVN ablation using a 3-D mapping system.

Purpose of the Study:

• To assess the feasibility and efficiency of His bundle pacing and AVN ablation guided by a 3-D mapping system.
• To evaluate the procedural outcomes and safety of this combined approach in patients with permanent AF.

Main Methods:

• Eighteen patients with permanent AF and refractory symptoms underwent His bundle pacing and AVN ablation.
• A CARTO3 system was used for electroanatomic 3-D mapping of the atria and ventricles.
• Lead implantation and AVN ablation were guided by real-time 3-D visualization.

Main Results:

• Successful implantation and AVN ablation were achieved in 17 out of 18 patients.
• Selective His bundle pacing occurred in 29.4% and nonselective in 70.6% of patients.
• Mean procedure time was 99.4 minutes, with a mean fluoroscopy time of 7.0 minutes.

Conclusions:

• His bundle pacing and AVN ablation guided by real-time 3-D mapping are highly feasible and efficient.
• This approach offers a promising therapeutic option for patients with refractory permanent AF.