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Left bundle branch pacing as an alternative to biventricular pacing for cardiac resynchronisation therapy
BACKGROUND: Left bundle branch pacing (LBBP) is a novel physiological pacing technique which may serve as an alternative to biventricular pacing (BVP) for the delivery of cardiac resynchronisation therapy (CRT). This study assessed the feasibility and outcomes of LBBP in comparison to BVP. METHODS:...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Bohn Stafleu van Loghum
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10033770/ https://www.ncbi.nlm.nih.gov/pubmed/35920989 http://dx.doi.org/10.1007/s12471-022-01712-9 |
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author | Rademakers, L. M. van den Broek, J. L. P. M. Bracke, F. A. |
author_facet | Rademakers, L. M. van den Broek, J. L. P. M. Bracke, F. A. |
author_sort | Rademakers, L. M. |
collection | PubMed |
description | BACKGROUND: Left bundle branch pacing (LBBP) is a novel physiological pacing technique which may serve as an alternative to biventricular pacing (BVP) for the delivery of cardiac resynchronisation therapy (CRT). This study assessed the feasibility and outcomes of LBBP in comparison to BVP. METHODS: LBBP was attempted in 40 consecutive patients as the first-line method for delivering CRT. To evaluate LBBP versus BVP, 40 patients with identical inclusion criteria who received BVP were compared with the LBBP group. Acute success rate, complications, functional and echocardiographic outcomes as well as hospitalisation for heart failure and all-cause mortality 6 months after implantation were evaluated. RESULTS: LBBP was successfully performed in 31 (78%) patients and resulted in significant QRS narrowing (from 166 ± 16 to 123 ± 18 ms, p < 0.001), improvement in left ventricular ejection fraction (LVEF; from 28 ± 8 to 43 ± 12%, p < 0.001) and New York Heart Association functional class (from 2.8 ± 0.5 to 1.6 ± 0.6, p < 0.001) at 6 months. No LBBP-related complications occurred. Compared to BVP, LBBP resulted in a greater reduction in QRS duration (44 ± 17 vs 15 ± 26 ms, p < 0.001) with comparable absolute improvement in LVEF (15.2 ± 11.7 vs 9.6 ± 12.1%, p = 0.088). Hospitalisation for heart failure and all-cause mortality were similar in the two groups. CONCLUSIONS: LBBP is feasible and was safe in 78% of patients with favourable electrical resynchronisation and functional improvement and may serve as an alternative to BVP. SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s12471-022-01712-9) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-10033770 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Bohn Stafleu van Loghum |
record_format | MEDLINE/PubMed |
spelling | pubmed-100337702023-03-24 Left bundle branch pacing as an alternative to biventricular pacing for cardiac resynchronisation therapy Rademakers, L. M. van den Broek, J. L. P. M. Bracke, F. A. Neth Heart J Original Article BACKGROUND: Left bundle branch pacing (LBBP) is a novel physiological pacing technique which may serve as an alternative to biventricular pacing (BVP) for the delivery of cardiac resynchronisation therapy (CRT). This study assessed the feasibility and outcomes of LBBP in comparison to BVP. METHODS: LBBP was attempted in 40 consecutive patients as the first-line method for delivering CRT. To evaluate LBBP versus BVP, 40 patients with identical inclusion criteria who received BVP were compared with the LBBP group. Acute success rate, complications, functional and echocardiographic outcomes as well as hospitalisation for heart failure and all-cause mortality 6 months after implantation were evaluated. RESULTS: LBBP was successfully performed in 31 (78%) patients and resulted in significant QRS narrowing (from 166 ± 16 to 123 ± 18 ms, p < 0.001), improvement in left ventricular ejection fraction (LVEF; from 28 ± 8 to 43 ± 12%, p < 0.001) and New York Heart Association functional class (from 2.8 ± 0.5 to 1.6 ± 0.6, p < 0.001) at 6 months. No LBBP-related complications occurred. Compared to BVP, LBBP resulted in a greater reduction in QRS duration (44 ± 17 vs 15 ± 26 ms, p < 0.001) with comparable absolute improvement in LVEF (15.2 ± 11.7 vs 9.6 ± 12.1%, p = 0.088). Hospitalisation for heart failure and all-cause mortality were similar in the two groups. CONCLUSIONS: LBBP is feasible and was safe in 78% of patients with favourable electrical resynchronisation and functional improvement and may serve as an alternative to BVP. SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s12471-022-01712-9) contains supplementary material, which is available to authorized users. Bohn Stafleu van Loghum 2022-08-03 2023-04 /pmc/articles/PMC10033770/ /pubmed/35920989 http://dx.doi.org/10.1007/s12471-022-01712-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Rademakers, L. M. van den Broek, J. L. P. M. Bracke, F. A. Left bundle branch pacing as an alternative to biventricular pacing for cardiac resynchronisation therapy |
title | Left bundle branch pacing as an alternative to biventricular pacing for cardiac resynchronisation therapy |
title_full | Left bundle branch pacing as an alternative to biventricular pacing for cardiac resynchronisation therapy |
title_fullStr | Left bundle branch pacing as an alternative to biventricular pacing for cardiac resynchronisation therapy |
title_full_unstemmed | Left bundle branch pacing as an alternative to biventricular pacing for cardiac resynchronisation therapy |
title_short | Left bundle branch pacing as an alternative to biventricular pacing for cardiac resynchronisation therapy |
title_sort | left bundle branch pacing as an alternative to biventricular pacing for cardiac resynchronisation therapy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10033770/ https://www.ncbi.nlm.nih.gov/pubmed/35920989 http://dx.doi.org/10.1007/s12471-022-01712-9 |
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