Evidence map›Paper›PMID 38649588›Full record

ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2024

Therapeutic potential of conduction system pacing as a method for improving cardiac output during ventricular tachycardia.

Daniel Keene, Alejandra A Miyazawa, Ahran D Arnold, Akriti Naraen, Nandita Kaza, Jagdeep S Mohal, David C Lefroy, Phang Boon Lim, Fu Siong Ng, Michael Koa-Wing and 8 more

Open access · hybridAbstract read
In one paragraph

Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 90% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 2 institutions in 2 countries.

Daniel KeeneImperial College Healthcare NHS Trust, London, UK. d.keene@imperial.ac.uk.ORCID http://orcid.org/0000-0001-7472-7358
Alejandra A MiyazawaImperial College Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0003-1958-7027
Ahran D ArnoldImperial College Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0002-7597-0170
Akriti NaraenImperial College Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0002-1681-2981
Nandita KazaImperial College London, National Heart and Lung Institute, London, UK.ORCID http://orcid.org/0000-0001-8725-5679
Jagdeep S MohalImperial College Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0002-0442-4033
David C LefroyImperial College Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0002-1595-8292
Phang Boon LimImperial College Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0003-4888-0070
Fu Siong NgImperial College Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0002-8681-4368
Michael Koa-WingImperial College Healthcare NHS Trust, London, UK.
Norman A QureshiImperial College Healthcare NHS Trust, London, UK.ORCID https://orcid.org/0000-0002-1385-5484
Nick W F LintonImperial College Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0002-5712-849X
Ian WrightImperial College Healthcare NHS Trust, London, UK.
Nicholas S PetersImperial College Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0002-3581-8078
Prapa KanagaratnamImperial College Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0003-3593-2185
Matthew J Shun-ShinImperial College Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0002-1179-0867
Darrel P FrancisImperial College Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0002-3410-0814
Zachary I WhinnettImperial College Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0002-2775-5126
Imperial College Healthcare NHS Trust · GBImperial College London · GB

Funding

British Heart Foundation FS/15/53/31615
6 · The paper itself

Abstract

backgroundVentricular tachycardia (VT) reduces cardiac output through high heart rates, loss of atrioventricular synchrony, and loss of ventricular synchrony. We studied the contribution of each mechanism and explored the potential therapeutic utility of His bundle pacing to improve cardiac output during VT.

methodsStudy 1 aimed to improve the understanding of mechanisms of harm during VT (using pacing simulated VT). In 23 patients with left ventricular impairment, we recorded continuous ECG and beat-by-beat blood pressure measurements. We assessed the hemodynamic impact of heart rate and restoration of atrial and biventricular synchrony. Study 2 investigated novel pacing interventions during clinical VT by evaluating the hemodynamic effects of His bundle pacing at 5 bpm above the VT rate in 10 patients.

resultsIn Study 1, at progressively higher rates of simulated VT, systolic blood pressure declined: at rates of 125, 160, and 190 bpm, -22.2%, -42.0%, and -58.7%, respectively (ANOVA p < 0.0001). Restoring atrial synchrony alone had only a modest beneficial effect on systolic blood pressure (+ 3.6% at 160 bpm, p = 0.2117), restoring biventricular synchrony alone had a greater effect (+ 9.1% at 160 bpm, p = 0.242), and simultaneously restoring both significantly increased systolic blood pressure (+ 31.6% at 160 bpm, p = 0.0003). In Study 2, the mean rate of clinical VT was 143 ± 21 bpm. His bundle pacing increased systolic blood pressure by + 14.2% (p = 0.0023). In 6 of 10 patients, VT terminated with His bundle pacing.

conclusionsRestoring atrial and biventricular synchrony improved hemodynamic function in simulated and clinical VT. Conduction system pacing could improve VT tolerability and treatment.

Indexed as

Cardiac OutputCardiac Pacing, ArtificialTachycardia, VentricularAgedBundle of HisElectrocardiographyFemaleHeart Conduction SystemHeart RateHumansMaleMiddle AgedTreatment OutcomeConduction system pacingHemodynamicHis bundle pacingMechanismVentricular tachycardiaVT

Identifiers

PMID38649588
PMCPMC11522067
OpenAlexW4395013217

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.