Cardiovascular Implantable Electronic Devices -> Bradycardia Devices: -> Clinical Trials D-MP10 - The Latest in His and Left Bundle Pacing (ID 53) Moderated ePoster

D-MP10-01 - Assessment Of Development Of New Onset Atrial Fibrillation Or Disease Progression With Permanent His Bundle Pacing Versus Right Ventricular Pacing (ID 706)


Background: Conventional right ventricular pacing (RVP) has been associated with an increased incidence of atrial fibrillation (AF). There is limited data on the impact of permanent His bundle pacing (HBP) on AF.
Objective: To compare the occurrence of new-onset AF and assess AF progression during long-term follow-up between HBP and RVP in patients (pts) undergoing dual chamber pacemaker (DC PPM) implantation.
Methods: We included all pts undergoing DC PPM implants at Rush University Medical center between 2016-2018. These pts were evaluated for new diagnosis of AF and progression of AF (defined as an increase of AF burden by 25%) as compared to first post-implant device check.
Results: A total of 575 pts underwent DC PPM implantation during the study period of which 196 pts (HBP N=93, RVP N=103) met the study inclusion criteria (figure 1). 134 pts (HBP n =66, RVP n = 68) had no history of atrial fibrillation and 107 patients (HBP n = 56, RVP n = 51) had ventricular pacing burden ≥ 20%. HBP was associated with reduction in risk of incident AF in all pts although this did not meet statistical significance (HR 0.561, 0.299 - 1.054, p = 0.072) (figure 1). However, among patients with a ventricular pacing burden ≥ 20%, HBP demonstrated significantly lower incidence of new AF (HR 0.324, 95 % CI 0.139 - 0.754, p = 0.009). There was no difference in progression of AF between the 2 groups in all comers (p = 0.373) or those with a ventricular pacing burden ≥ 20% (p = 0.423).
Conclusion: HBP is associated with lower risk of new onset AF in patients with ventricular pacing ≥ 20% compared to RVP. There was no difference in risk of AF progression.