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His bundle pacing in patients with permanent atrial fibrillation and heart failure with non-reduced ejection fraction – retrospective study

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Skonieczny B., Sławuta A., Radziejewska J., Jagielski D., Gajek J., Kozłowski D.
European Journal of Translational and Clinical Medicine
|
2023
|
vol. 6
|
issue 2
45-50
EN
Background: Heart failure [HF] constitutes a complex clinical entity and often coexists with atrial fibrillation [AF]. There is scarcity of evidence-based therapies for those with ejection fraction [EF] ≥ 40%. Effect of regularization of ventricular response in patients with HF with EF ≥ 40% and concomitant atrial fibrillation is unknown. Material and methods: This was a retrospective case-series study. 14 patients with symptomatic HF with EF ≥ 40% and permanent atrial fibrillation who had undergone pHBP were identified and enrolled. For 9 patients pHBP was a primary strategy, for the remaining patients it was an upgrade from right ventricular lead. All patients underwent follow-up visit 3 months after the procedure. Results: NYHA class was significantly reduced (mean 2.5 vs. 1.0, p-value < 0.001). Left ventricular ejection fraction significantly increased mean increase 8.5%, 95% CI 7.7–9.2, p < 0.001) Similarly, significant decrease in left ventricular end diastolic diameter was observed (mean decrease 5.4 mm, 95% CI 5.0–5.8 mm, p < 0.001). The degree of mitral regurgitation after three months was lower (mean grade 2.4 vs. 1.2, p < 0.001). At follow-up prescribed doses of beta blocker were higher (mean metoprolol equivalent dose rose by 69.6 mg). Conclusions: Permanent His bundle pacing might be beneficial in the setting of permanent AF and HF with EF ≥ 40%.
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