Pacing-Induced Cardiomyopathy
Conditions
Keywords
left bundle branch area pacing; atrial fibrillation; atrioventricular ablation; pacing-induced cardiomyopathy
Brief summary
Permanent ventricular pacing may be complicated with ventricular dyssynchrony and subsequent pacing-induced cardiomyopathy. We hypothesized that left bundle branch area pacing may prevent the development of pacing-induced cardiomyopathy in patients with permanent atrial fibrillation requiring permanent ventricular pacing. Patients with permanent atrial arrhythmia with an indication of cardiac pacing and atrioventricular junction ablation will be prospectively enrolled. They will undergo the implantation of a single-chamber pacemaker with left bundle branch area pacing, and then atrioventricular junction ablation. They will be prospectively followed during 6 months.
Detailed description
Patients with permanent atrial arrhythmia with an indication of cardiac pacing and atrioventricular junction ablation will be prospectively enrolled. They will undergo the implantation of a single-chamber pacemaker with left bundle branch area pacing confirmed according to electrocardiographic parameters. Atrioventricular node ablation will be performed the following day through a femoral venous approach. Perioperative data and potential complications will be collected. Patients will be prospectively followed during 6 months. They will have clinical examination, 12-lead ECG, and an echocardiography.
Interventions
DEVICESingle-chamber pacemaker implantation with left bundle branch area pacing
A prepectoral single-chamber pacemaker is implanted with a 3830 (Medtronic) IS-1 pacing lead screwed via the right ventricle in the deep interventricular septum in order to capture the left Purkinje system on the left ventricular endocardial side.
Sponsors
Dr Arnaud BISSON
Nicolas Clementy, MD, PhD
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* Permanent atrial arrhythmia * Symptoms related to an insufficient rate control under optimal medical therapy
Exclusion criteria
* Indication of prophylactic defibrillator * Already implanted with a cardiac device
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Heart failure hospitalization | 6 months | Hospitalization for decompensated heart failure |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mortality | 6 months | Death from any cause |
| Electrical remodeling | 6 months | QRS width |
| Complications | 30 days | Perioperative complications |
| Volumetric response | 6 months | Left ventricular ejection fraction, left ventricular volumes |
Countries
France
Contacts
Primary ContactNicolas CLEMENTY
Outcome results
None listed