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Effects of His bundle pacing and right ventricular apex pacing on cardiac electrical and mechanical synchrony and cardiac function in patients with heart failure and atrial fibrillation.

OBJECTIVE
To investigate the effects of right ventricular apex pacing and His bundle pacing on cardiac mechanical and electrical synchrony and cardiac function in patients with heart failure and atrial fibrillation.


METHODS
A total of 72 patients with heart failure and atrial fibrillation who received permanent pacemaker implantation in our hospital were randomly divided into two groups, with 36 patients in each group. The control group received the right ventricular apex pacing, and the study group received His bundle pacing. In the two groups, the pacing parameters, cardiac function, cardiac electricity, mechanical synchrony, complications and living quality were compared.


RESULTS
During operation and 12 months after the operation, the study group's pacing threshold was higher than the pacing threshold of the control group (all P<0.001). Compared with that before the procedure, NYHA grade and LVEDD of the two groups 12 months after operation were decreased (all P<0.001), while LVEF and various quality of life scores were increased (all P<0.001). The study group's NYHA grade and LVEDD were lower than those of the control group 12 months after operation (all P<0.001), while the study group's quality of life scores and LVEF were higher than those of the control group (all P<0.001). Twelve months after operation, the study group's QRS width and IVMD were lower than QRS width and IVMD of the control group (all P<0.001). The study group's complication rate was 5.56% (2/36), which was lower than the control group's complication rate (22.22% (8/36), P<0.05).


CONCLUSION
Compared with right ventricular apical pacing, His bundle pacing in the treatment of heart failure with atrial fibrillation can better maintain the cardiac electrical and mechanical synchronization, promote the recovery of cardiac function, improve living quality, and has fewer complications and significant advantages.