[Choice of the mode of stimulation after ablation of the bundle of His. Experience based on a retrospective survey of 192 patients].
A retrospective study of 192 patients centered on the outcome of supraventricular arrhythmias after catheter ablation of the atrioventricular junction provided some useful information concerning the choice of pacing mode in these patients. With the exception of atrioventricular bloc after ablation of the rapid nodal pathway where simple DDD pacing is adequate, rate adaptive pacing would seem to be essential. The VVIR mode should be the mode of choice in atrial flutter, permanent atrial fibrillation, poorly controlled atrial fibrillation and paroxysmal atrial fibrillation of elderly subjects (over 70 years) and/or of male sex, and/or complicating advanced cardiac disease (valvular, ischaemic or primary). The DDDR mode (with an algorithm to prevent endless loop tachycardia) is the mode of choice in sinus node dysfunction and/or in young patients (under 60), and/or females and/or in idiopathic arrhythmias and/or when retrograde VA conduction persists. When the pacemaker is replaced, the indication should be reviewed with respect to the outcome of the arrhythmia, which underlines the value of accurate implanted Holter systems.
Bernard
V
V
Hôpital cardiologique, Université de Bordeaux, Pessac.
Clémenty
J
J
Gencel
L
L
Poquet
F
F
Haïssaguerre
M
M
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D002036:Bundle of His / Q000601:surgery*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004564:Electrocoagulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012189:Retrospective Studies; D013997:Time Factors
Choix du mode de stimulation après ablation du faisceau de His. Expérience tirée d'une enquête rétrospective portant sur 192 malades.