Ablation/Modification of Atrioventricular Junction for Heart Rate Control of Permanent Atrial Fibrillation
Journal
Huang S Catheter Ablation of Cardiac Arrhythmias
Series/Report No.
Huang S Catheter Ablation of Cardiac Arrhythmias
Start Page
428-436
ISBN
[9780323931120, 9780323931106]
Date Issued
2024-01-01
Author(s)
Abstract
Mapping the His bundle uses a combined anatomy- and electrogram-guided approach. The right-sided approach is targeted at just proximal to or below the His bundle electrode position on the fluoroscopic view, or at the proximal His location. The left-sided approach is targeted at just below the aortic valve at the septal site where a His potential can be recorded. If the His potential is not recorded at the upper septal site, it may be recorded in the noncoronary sinus cusp. Sources of difficulties include inability to record the His potential and failure of the right-sided approach. Successful atrioventricular junction ablation allows 100% biventricular pacing with CRT in patients with AF and reduced ventricular function. His bundle pacing or left bundle branch area pacing is a novel promising technique to deliver resynchronized therapy in AF patients undergoing atrioventricular junction ablation. AV node modification is not recommended because of lack of benefits and yet at higher risks as compared with complete AV junction ablation with pacemaker.
Publisher
Elsevier
Type
book part