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Antitachycardia pacing at the His bundle is safer than conventional right ventricular antitachycardia pacing in a canine myocardial ischemic injury model.
Hirahara, Annie M; Khan, Muhammad S; Gharbia, Omar A; Lange, Matthias; Ishidoya, Yuki; Smego, Douglas; Ranjan, Ravi; Stoddard, Gregory J; Selzman, Craig H; Dosdall, Derek J.
Afiliação
  • Hirahara AM; Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.
  • Khan MS; Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah, USA.
  • Gharbia OA; Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah, USA.
  • Lange M; Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah, USA.
  • Ishidoya Y; Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah, USA.
  • Smego D; Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah, USA.
  • Ranjan R; Department of Surgery, Division of Cardiothoracic Surgery, University of Utah, Utah, Salt Lake City, USA.
  • Stoddard GJ; Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA.
  • Selzman CH; Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, Utah, USA.
  • Dosdall DJ; Department of Internal Medicine, Division of Cardiovascular Medicine, University of Utah, Salt Lake City, Utah, USA.
J Cardiovasc Electrophysiol ; 34(5): 1249-1256, 2023 05.
Article em En | MEDLINE | ID: mdl-37125623
INTRODUCTION: Antitachycardia pacing (ATP) is used to terminate ventricular tachycardia (VT) by delivering rapid, low energy pacing to the right ventricle (RV). Unfortunately, ATP is not effective against all VT episodes and can result in adverse outcomes, such as VT acceleration and degeneration into ventricular fibrillation (VF). Improving ATP is therefore desirable. Our objective was to compare the efficacy and safety of ATP delivered at the His bundle to traditional ATP. METHODS: Six dogs were anesthetized and pacing leads were implanted in the RV and His bundle. The left anterior descending artery was occluded for 2 h to create an ischemic injury. In a study 4-7 days later, a 128-electrode sock was placed snugly around the ventricles and VT was induced using rapid pacing. ATP was delivered from either the His bundle or RV lead, then attempted at the other location if unsuccessful. Success rates and instances of VT acceleration and degeneration into VF were calculated. RESULTS: We induced 83 runs of VT and attempted ATP 128 times. RV ATP was successful in 36% of attempts; His ATP was successful in 38% of attempts. RV ATP resulted in significantly more adverse outcomes. RV and His ATP induced VT acceleration in 9% and 3% of trains, respectively, and induced degeneration into VF in 5% and 1% of trains, respectively. CONCLUSION: His bundle ATP is safer, but not significantly more effective, than RV ATP.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Taquicardia Ventricular / Desfibriladores Implantáveis Tipo de estudo: Diagnostic_studies / Prognostic_studies Limite: Animals Idioma: En Revista: J Cardiovasc Electrophysiol Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / FISIOLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Taquicardia Ventricular / Desfibriladores Implantáveis Tipo de estudo: Diagnostic_studies / Prognostic_studies Limite: Animals Idioma: En Revista: J Cardiovasc Electrophysiol Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / FISIOLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos