Comparison of Clinical Complications Between LBBAP and Traditional RVP in Long-Term Follow-Up.

IF 0.5 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Kardiologiya Pub Date : 2025-01-31 DOI:10.18087/cardio.2025.1.n2809

Jieruo Chen, Zefeng Wang, Fei Hang, Yongquan Wu

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引用次数: 0

Abstract

Background: Traditional right ventricular pacing (RVP) can lead to asynchronous cardiac mechanical contractions and increase the risk of adverse cardiac events. This study aimed to compare the clinical complications between left bundle branch area pacing (LBBAP), which is both novel and physiological, and RVP in a cohort requiring ventricular pacing.

Material and methods: A retrospective study was conducted on patients with initial implantation of a dual-chamber, permanent pacemaker and with ventricular pacing proportion more than 20 % from January 2019 to December 2020. Patients were divided into the LBBAP or RVP group and follow-up was conducted routinely. The primary outcome was ventricular lead complications, including an increase in the ventricular lead threshold or a decrease in R-wave amplitude. Overall complications were defined as ventricular lead complications, ventricular lead dislocation, ventricular lead perforation, adverse cardiovascular events and cardiovascular death.

Results: A total of 248 patients were included in the analysis (LBBAP, n=98; RVP, n=150). The pacing QRS duration in LBBAP patients was significantly shorter than in RVP patients (110.3±22.7 vs 140.0±29.3 ms, p<0.01). For a mean follow-up duration of 13 mos, the risk of ventricular lead complications was higher in the LBBAP group than in the RVP group (62.0 % vs. 36.5 %, p=0.03). LBBAP was comparable to RVP within one year follow-up when considering overall complications. At the one year follow-up ultrasound examinations, the LA in LBBAP group was decreased (p=0.04). Considering the larger initial left ventricular end-diastolic diameter (LVEDD) in the LBBAP group, the similarity of LVEDD values in both groups at follow-up suggested that LVEDD was reduced in patients treated with LBBAP. There was no difference in left ventricular ejection fraction (LBBAP LVEF, baseline = 61.2±8.6 %) between the two groups at baseline or follow-up.

Conclusions: LBBAP patients were more prone to ventricular lead threshold increase and amplitude decrease than RVP patients. The risk of overall complications in the two pacing modalities were equal in one year follow-up duration. LBBAP is safe and effective in patients with VP>20 % and without seriously depressed LVEF.

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来源期刊

Kardiologiya 医学-心血管系统

CiteScore

1.70

自引率

20.00%

发文量

审稿时长

3-8 weeks

期刊介绍： “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.