RT Journal Article
T1 Left bundle branch area pacing in patients with heart failure and right bundle branch block: Results from International LBBAP Collaborative-Study Group
A1 Vijayaraman, Pugazhendhi
A1 Cano, Oscar
A1 Ponnusamy, Shunmuga Sundaram
A1 Molina-Lerma, Manuel
A1 Chan, Joseph Y. S.
A1 Padala, Santosh K.
A1 Sharma, Parikshit S.
A1 Whinnett, Zachary I.
A1 Herweg, Bengt
A1 Upadhyay, Gaurav A.
A1 Subzposh, Faiz A.
A1 Patel, Neil R.
A1 Beer, Dominik A.
A1 Bednarek, Agnieszka
A1 Kielbasa, Grzegorz
A1 Tung, Roderick
A1 Ellenbogen, Kenneth A.
A1 Jastrzebski, Marek
K1 Cardiac resynchronization therapy
K1 Left bundle branch area pacing
K1 Right bundle branch block
K1 Heart failure
K1 Cardiomyopathy
K1 Cardiac-resynchronization therapy
K1 Qrs morphology
K1 Defibrillator
K1 Metaanalysis
K1 Reduction
K1 Mortality
AB Cardiac resynchronization therapy (CRT) using biventricular pacing has limited efficacy in patients with heart failure (HF) and right bundle branch block (RBBB). Left bundle branch area pacing (LBBAP) is a novel physiologic pacing option. OBJECTIVE The aim of the study was to assess the feasibility and outcomes of LBBAP in HF patients with RBBB and reduced left ventricular systolic function, and indication for CRT or ventricular pacing. METHODS LBBAP was attempted in patients with left ventricular ejection fraction (LVEF) = 5% increase in ejection fraction) to LBBAP were assessed. RESULTS LBBAP was attempted in 121 patients and successful in 107 (88%). Patient characteristics included age 74 +/- 12 years, female 25%, ischemic cardiomyopathy 49%, and ejection fraction 35% +/- 9%. QRS axis at baseline was normal in 24%, left axis 63%, right axis 13%. LBBAP threshold and R-wave amplitudes were 0.8 +/- 0.3 V@ 0.5 ms and 10 +/- 9 mV at implant and remained stable during mean follow-up of 13 +/- 8 months. LBBAP resulted in narrowing of QRS duration (156 +/- 20 ms to 150 +/- 24 ms (P = .01) with R-wave peak times in V-6 of 85 +/- 16 ms. LVEF improved from 35% +/- 9% to 43% +/- 12% (P,.01). Clinical and echocardiographic response was observed in 60% and 61% of patients, respectively. Female sex and reduction in QRS duration with LBBAP were predictive of echocardiographic response and super-response. CONCLUSION LBBAP is a feasible alternative to deliver CRT or physiologic ventricular pacing in patients with RBBB, HF, and LV dysfunction.
PB Elsevier
SN 2666-5018
YR 2022
FD 2022-08-01
LK http://hdl.handle.net/10668/22256
UL http://hdl.handle.net/10668/22256
LA en
DS RISalud
RD Apr 8, 2025