Comparison between his-bundle pacing and left bundle branch pacing in patients with atrioventricular block
- PDF / 2,118,006 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 98 Downloads / 216 Views
Comparison between his-bundle pacing and left bundle branch pacing in patients with atrioventricular block Yiran Hu 1,2 & Hui Li 3 & Min Gu 2 & Wei Hua 2 & Hongxia Niu 2 & Nixiao Zhang 3 & Xi Liu 3 & Xuhua Chen 3 & Cuihong Hou 3 & Xiaohong Zhou 4 & Shu Zhang 3 Received: 22 April 2020 / Accepted: 4 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Pacing the cardiac conduction system has been explored in patients with conduction system disease, but comprehensive comparisons between different pacing modalities are not well investigated. Objective To compare pacing characteristics and ventricular synchrony between His-bundle pacing (HBP) and left bundle branch pacing (LBBP) in patients with atrioventricular block (AVB). Methods Fifty pacemaker-indicated patients with AVB were enrolled. Twenty-five patients underwent HBP, and another 25 patients underwent LBBP. Success rate, procedural and fluoroscopy duration, pacing parameters, and echocardiographic data were perioperatively assessed and at 3-month follow-up. Results HBP was successful in 19 of 25 (76.0%) patients, whereas LBBP was successful in 22 of 25 (88.0%) patients. Compared with HBP, LBBP capture threshold was significantly lower (0.76 ± 0.25 V/0.4 ms vs. 1.27 ± 0.61 V/1.0 ms, P = 0.003) and Rwave amplitude was significantly higher with LBBP (11.7 ± 6.6 vs. 4.9 ± 2.4 mV, P < 0.001) at implant. The mean procedural time (74.3 ± 17.8 vs. 63.2 ± 12.3 min, P = 0.029) and fluoroscopy duration (10.3 ± 4.5 vs. 6.8 ± 2.2 min, P = 0.005) were significantly longer in the HBP group compared to LBBP. At 3-month follow-up, pacing capture threshold remained more stable in LBBP than in HBP group while left ventricular synchrony was similar between both groups. Conclusion Despite similar impact on ventricular synchrony compared with HBP, LBBP featured a significantly lower pacing capture threshold, higher R-wave amplitude, and less time to achieve similar success rate in patients with AVB. These findings indicate LBBP as a physiological pacing strategy for AVB patients. Keywords His-bundle pacing . Left bundle branch pacing . Atrioventricular block . Physiological pacing
1 Introduction Yiran Hu, Hui Li and Min Gu contributed equally to this work. * Wei Hua [email protected] 1
Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring West Road, Beijing 100070, China
2
The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, NO.167, Beilishi Road, Xicheng District, Beijing100037, China
3
Department of Ultrasound, Fuwai Hospital, National Center for Cardiovascular Disease, Beijing, China
4
Cardiac Rhythm and Heart Failure, Medtronic plc, Mounds View, MN 55112, USA
Traditional right ventricular apical pacing (RVAP) is associated wit
Data Loading...
