Endocardial Transcatheter Stimulation of the AV Nodal Fat Pad: Stabilization of Rapid Ventricular Rate Response During Atrial Fibrillation in Left Ventricular Failure

被引：14

作者：

Bianchi, Stefano ^{[1
]}

Rossi, Pietro ^{[2
]}

Della Scala, Alberto ^{[3
]}

Kornet, Lilian ^{[4
]}

机构：

[1] S Giovanni Calibita Fatebenefratelli Hosp, Div Cardiol, Rome, Italy

[2] Belcolle Hosp, Dept Med, Viterbo, Italy

[3] Medtron Italy, Milan, Italy

[4] Medtron Bakken Res Ctr, Maastricht, Netherlands

来源：

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY | 2009年 / 20卷 / 01期

关键词：

arrhythmia; atrial fibrillation; atrioventricular node; parasympathetic stimulation; pacing; PARASYMPATHETIC NERVES; VAGAL-STIMULATION; HUMANS;

D O I：

10.1111/j.1540-8167.2008.01243.x

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Stabilized Rate with Endocardial Vagal Stimulation. Introduction: Recent acute studies demonstrated that atrioventricular (AV) node vagal stimulation during atrial fibrillation (AF) decreases the mean ventricular rate, thus improving hemodynamics. Methods and Results: We report a case of a woman with acute heart failure (HF), chronic AF with untreatable ventricular rapid response, in severe hypotensive state due to a cardiogenic shock. The patient underwent left ventricular (LV) pacemaker implantation and received 50 Hz AV node stimulation, delivered through a posteroseptal atrial lead, thus allowing a 100% pacing. Hemodynamics improvements allowed carvedilol titration; the rate was below 85 bpm after 4 days, then the atrial lead was removed. Conclusions: This novel strategy may allow controlling the rapid AV response in patients undergoing pacemaker implantation. (J Cardiovasc Electrophysiol, Vol. 20, pp. 103-105, January 2009).

引用

页码：103 / 105

页数：3

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