biostudies-literatureUnknown9(22)Ravi VBackground Conventional right ventricular pacing (RVP) has been associated with an increased incidence of atrial fibrillation (AF). We sought to compare the occurrence of new-onset AF and assessed AF disease progression during long-term follow-up between His bundle pacing (HBP) and RVP. Methods and Results We included patients undergoing initial dual-chamber pacemaker implants at Rush University Medical Center between January 1, 2016, and June 30, 2019. A total of 360 patients were evaluated, and 225 patients (HBP, n=105; RVP, n=120) were included in the study. Among the 148 patients (HBP, n=72; RVP, n=76) with no history of AF, HBP demonstrated a lower risk of new-onset AF (adjusted hazard ratio [HR], 0.53; 95% CI, 0.28-0.99; <i>P</i>=0.046) compared with traditional RVP. This benefit was observed with His or RVP burden exceeding 20% (HR, 0.29; 95% CI, 0.13-0.64; <i>P</i>=0.002), ≥40% (HR, 0.31; <i>P</i>=0.007), ≥60% (HR, 0.35; <i>P</i>=0.015), and ≥80% (HR, 0.40; <i>P</i>=0.038). There was no difference with His or RV pacing burden <20% (HR, 0.613; 95% CI, 0.213-1.864; <i>P</i>=0.404). In patients with a prior history of AF, there was no difference in AF progression (<i>P</i>=0.715); however, in a subgroup of patients with a pacing burden ≥40%, HBP demonstrated a trend toward a lower risk of AF progression (HR, 0.19; 95% CI, 0.03-1.16; <i>P</i>=0.072). Conclusions HBP demonstrated a lower risk of new-onset AF compared with RVP, which was primarily observed at a higher pacing burden.Journal of the American Heart Associatione018478https://www.ebi.ac.uk/biostudies/studies/S-EPMC7763709biostudies-literatureDevelopment of New-Onset or Progressive Atrial Fibrillation in Patients With Permanent HIS Bundle Pacing Versus Right Ventricular Pacing: Results From the RUSH HBP Registry.PMC7763709Larsen TVijayaraman PSharma PSRavi VTrohman RGHanifin JLKrishnan KOoms SBeer DPietrasik GMHuang HDAyub MTfalseDevelopment of New-Onset or Progressive Atrial Fibrillation in Patients With Permanent HIS Bundle Pacing Versus Right Ventricular Pacing: Results From the RUSH HBP Registry.Background Conventional right ventricular pacing (RVP) has been associated with an increased incidence of atrial fibrillation (AF). We sought to compare the occurrence of new-onset AF and assessed AF disease progression during long-term follow-up between His bundle pacing (HBP) and RVP. Methods and Results We included patients undergoing initial dual-chamber pacemaker implants at Rush University Medical Center between January 1, 2016, and June 30, 2019. A total of 360 patients were evaluated, and 225 patients (HBP, n=105; RVP, n=120) were included in the study. Among the 148 patients (HBP, n=72; RVP, n=76) with no history of AF, HBP demonstrated a lower risk of new-onset AF (adjusted hazard ratio [HR], 0.53; 95% CI, 0.28-0.99; <i>P</i>=0.046) compared with traditional RVP. This benefit was observed with His or RVP burden exceeding 20% (HR, 0.29; 95% CI, 0.13-0.64; <i>P</i>=0.002), ≥40% (HR, 0.31; <i>P</i>=0.007), ≥60% (HR, 0.35; <i>P</i>=0.015), and ≥80% (HR, 0.40; <i>P</i>=0.038). There was no difference with His or RV pacing burden <20% (HR, 0.613; 95% CI, 0.213-1.864; <i>P</i>=0.404). In patients with a prior history of AF, there was no difference in AF progression (<i>P</i>=0.715); however, in a subgroup of patients with a pacing burden ≥40%, HBP demonstrated a trend toward a lower risk of AF progression (HR, 0.19; 95% CI, 0.03-1.16; <i>P</i>=0.072). Conclusions HBP demonstrated a lower risk of new-onset AF compared with RVP, which was primarily observed at a higher pacing burden.2020-01-01T00:00:00Z2020 Nov2024-02-15T06:30:16.9Z2021-02-20T16:54:53ZS-EPMC77637093317450910.1161/JAHA.120.018478