Immediate clinical outcomes of left bundle branch area pacing vs conventional right ventricular pacing

Background Left bundle branch area pacing (LBBaP) is a new physiological pacing strategy that produces comparable clinical effects to His bundle pacing (HBP). Objective The purpose of this study was to investigate the immediate clinical outcomes of LBBaP vs RVP. Methods and Results From April 2018 t...

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Published in:Clinical cardiology (Mahwah, N.J.) Vol. 42; no. 8; pp. 768 - 773
Main Authors: Zhang, JunMeng, Wang, Zefeng, Cheng, Liting, Zu, Linna, Liang, Zhuo, Hang, Fei, Wang, Xinlu, Li, Xiaoyan, Su, Ruijuan, Du, Jie, Wu, Yongquan
Format: Journal Article
Language:English
Published: New York Wiley Periodicals, Inc 01.08.2019
John Wiley & Sons, Inc
Subjects:
Aged
Bundle of His - physiopathology
Bundle-Branch Block - physiopathology
Bundle-Branch Block - therapy
Cardiac Pacing, Artificial - methods
Clinical Investigations
Clinical outcomes
Electrocardiography
Female
Follow-Up Studies
Heart Rate - physiology
Heart Ventricles - physiopathology
Humans
left bundle branch area pacing
Male
Middle Aged
physiological pacing
Physiology
QRS complex
Retrospective Studies
right ventricular pacing
Stroke Volume - physiology
Treatment Outcome
Ventricular Function, Right - physiology
Beijing China
New York
left bundle branch area pacing
physiological pacing
right ventricular pacing
QRS complex
ISSN:0160-9289, 1932-8737, 1932-8737
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Summary:Background Left bundle branch area pacing (LBBaP) is a new physiological pacing strategy that produces comparable clinical effects to His bundle pacing (HBP). Objective The purpose of this study was to investigate the immediate clinical outcomes of LBBaP vs RVP. Methods and Results From April 2018 to September 2018, we included 44 patients under continuous pacemaker implantation. Patients were randomly divided into the LBBaP group and conventional RVP group. Compared to the RVP group, the LBBaP group displayed significantly increased operative (90.10 ± 19.68 minutes vs 61.57 ± 6.62 minutes, P < .001) and X‐ray exposure times (15.55 ± 5.62 minutes vs 4.67 ± 2.06 minutes, P < .001). The lead threshold of the LBBaP group was increased (0.68 ± 0.20 mV vs 0.51 ± 0.0 mV, P = .001), while the R‐wave amplitude and ventricular impedance did not significantly differ between the two groups. The conventional RVP procedure significantly widened the QRS complex (93.62 ± 8.28 ms vs 135.19 ± 12.21 ms, P = .001), whereas the LBBaP had no effect on QRS complex (130.13 ± 43.30 ms vs 112.63 ± 12.14 ms, P = .904). Furthermore, the LBBaP procedure significantly narrowed the QRS complex in patients with left bundle branch block (LBBB) (168.43 ± 38.870 ms vs 119.86 ± 6.69 ms, P = .019). Conclusion LBBaP is a new physiological, safe and effective pacing procedure with a high overall success rate. Compared to conventional RVP, LBBaP can correct LBBB, thereby improving cardiac electrical dyssynchrony.
Bibliography:Funding information
National Natural Science Foundation of China
ObjectType-Article-1
SourceType-Scholarly Journals-1
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JunMeng Zhang and Zefeng Wang are contributed equally.
Funding information National Natural Science Foundation of China
ISSN:0160-9289
1932-8737
1932-8737
DOI:10.1002/clc.23215