Su Lan, Xia Xue, Liang Dongjie, Wu Shengjie, Xu Lei, Xu Tiancheng, Wang Songjie, Chen Xiao, Huang Weijian
Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
The Key Lab of Cardiovascular Disease, Science and Technology of Wenzhou, Wenzhou, China.
Front Cardiovasc Med. 2020 Dec 17;7:585165. doi: 10.3389/fcvm.2020.585165. eCollection 2020.
Antiarrhythmic drug therapy can affect pacemaker parameters in both the atrial and ventricular myocardium. It is not known whether antiarrhythmic drugs impact His bundle pacing/sensing parameters and His to ventricle (H-V) intervals following permanent His bundle pacing (HBP). The aims of the study were to prospectively determine the influence of rhythm and rate-controlling drugs on pacing parameters and H-V conduction after His bundle lead implantation and to assess the impact of rhythm and rate-controlling drugs on the safety of HBP. Patients ( = 140) with QRS duration < 120 ms who met permanent pacing indications were prospectively enrolled. Propafenone, lidocaine, and adenosine were injected intravenously after implantation of 3,830 lead during the procedure. Metoprolol succinate, amiodarone, and digoxin were taken orally for 1 month. Pacing parameters before and after drug intervention was measured, including His capture threshold, sensing and impedance, H-V interval, and conduction. There were no statistically significant differences in His bundle pacing thresholds, impedance, and sensing after drug intervention at implantation or during a 2-month follow-up ( > 0.05). The HV interval was not affected except in the large-dose propafenone group where HV interval prolonged ( = 0.001). All patients maintained 1:1 H-V conduction following drug administration. There was no adverse impact on the HBP parameters or H-V conduction after the administration of commonly used dosage of rhythm and rate-controlling drugs. The drugs were safe in patients with permanent His bundle pacing.
抗心律失常药物治疗可影响心房和心室心肌的起搏器参数。目前尚不清楚抗心律失常药物在永久性希氏束起搏（HBP）后是否会影响希氏束起搏/感知参数以及希氏束至心室（H-V）间期。本研究的目的是前瞻性地确定节律和心率控制药物对希氏束导线植入后起搏参数和H-V传导的影响，并评估节律和心率控制药物对HBP安全性的影响。前瞻性纳入了140例符合永久性起搏指征且QRS波时限<120 ms的患者。在手术过程中植入3830根导线后，静脉注射普罗帕酮、利多卡因和腺苷。口服琥珀酸美托洛尔、胺碘酮和地高辛1个月。测量药物干预前后的起搏参数，包括希氏束夺获阈值、感知和阻抗、H-V间期以及传导情况。在植入时或2个月随访期间进行药物干预后，希氏束起搏阈值、阻抗和感知方面均无统计学显著差异（P>0.05）。除大剂量普罗帕酮组H-V间期延长外（P=0.001），H-V间期未受影响。给药后所有患者均维持1:1的H-V传导。常用剂量的节律和心率控制药物给药后对HBP参数或H-V传导无不良影响。这些药物对永久性希氏束起搏患者是安全的。
