Pulmonary Artery Pressure and Right Heart Evaluation for Patients Requiring Physiological Pacing Treatment
Heart Failure With Reduced Ejection Fraction, Atrial Fibrillation, Persistent, Sick Sinus Syndrome
About this trial
This is an interventional treatment trial for Heart Failure With Reduced Ejection Fraction focused on measuring physiological pacing, right heart, hemodynamics examination, acute and chronic impact
Eligibility Criteria
Inclusion Criteria:
- age over 18
- persistent atrial fibrillation patients with uncontrolled heart rate requiring atrioventricular node ablation
- patients with sick sinus syndrome or atrioventricular block eligible for pacemaker implantation
- patients who can understand and sign informed consent
Exclusion Criteria:
- age below 18 or over 99
- concomitant diseases that may affect right heart function, including COPD, pulmonary infection, history of pulmonary embolism or right myocardial infarction, myocarditis, systemic disease
- patients with temporary pacemaker implanted
- right heart catheterization contraindications, including acute infection and embolic events
Sites / Locations
- Shanghai Tenth People's HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Active Comparator
Active Comparator
His bundle pacing group
Left branch bundle pacing group
Right ventricular pacing group
HBP was performed on the patient, and the detection of the His bundle potential during the procedure is the sign of the success of the procedure. The HB capture threshold was accepted if lower than 3.0 V at 0.42ms.
HBP was performed on the patient, and the detection of the His bundle potential during the procedure is the sign of the success of the procedure. During the procedure, the duration from the pacing signal to the peak of R wave (on V4-V6 lead) is measured as pacing to left ventricular activation time (p-LVAT). An eligible site of left bundle capture was confirmed if selective LBBP was demonstrated by ECG, if p-LVAT shortened abruptly >10 ms through increasing pacing output, or if p-LVAT stayed shortest and stable at the site.
If we could not achieve an acceptable HB or LBB capture after five attempts of lead positioning or a fluoroscopy exposure time over 30min, the lead was then placed in the RV with traditional approach.