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Mid-term feasibility, safety and outcomes of left bundle branch pacing-single center experience.
J Interv Card Electrophysiol. 2020 Jul 04 [Online ahead of print]JI

Abstract

BACKGROUND

His bundle pacing (HBP) has evolved as the most physiological form of pacing but associated with limitations. Recently, left bundle branch pacing (LBBP) is emerging as an effective alternative strategy for HBP.

OBJECTIVES

Our study was designed to assess the feasibility, efficacy, electrophysiological parameters, and mid-term outcomes of LBBP in Indian population.

METHODS

All patients requiring permanent pacemaker implantation for symptomatic bradycardia and heart failure were prospectively enrolled. Echocardiography, QRS duration, pacing parameters, left bundle (LB) potentials, paced QRS duration, and peak left ventricular activation time (pLVAT) were recorded.

RESULTS

LBBP was successful in 93 out of 99 patients (94% acute success). Mean age was 62.6 ± 13 years, male 59%, diabetes 69%, and coronary artery disease 65%. Follow-up duration was 4.8 months (range1-12 months). Indication for pacing included atrioventricular (AV) block 43%, cardiac resynchronization therapy 44%, and AV node ablation 4%. LB potential was noted in 37 patients (40%). QRS duration reduced from 144.38 ± 34.6 at baseline to 110.8 ± 12.4 ms after LBBP (p < 0.0001). Pacing threshold was 0.59 ± 0.22 V and sensed R wave 14.14 ± 7.19 mV, and it remained stable during follow-up. Lead depth in the septum was 9.62 mm. LV ejection fraction increased from 44.96 to 53.3% after LBBP (p < 0.0001). One died due to respiratory tract infection on follow up.

CONCLUSION

LBBP is a safe and effective strategy (94% acute success) of physiological pacing. The pacing parameters remained stable over a period of 12 months follow-up. LBBP can effectively overcome the limitations of HBP.

Authors+Show Affiliations

Department of Cardiology, Velammal Medical College Hospital and Research Institute, Velammal Village, Airport ring road, Madurai, Tamilnadu, 625009, India. shunmuga.pgi@gmail.com.Department of Cardiology, Velammal Medical College Hospital and Research Institute, Velammal Village, Airport ring road, Madurai, Tamilnadu, 625009, India.Department of Cardiology, Velammal Medical College Hospital and Research Institute, Velammal Village, Airport ring road, Madurai, Tamilnadu, 625009, India.Department of Cardiology, Velammal Medical College Hospital and Research Institute, Velammal Village, Airport ring road, Madurai, Tamilnadu, 625009, India.Department of Cardiology, Velammal Medical College Hospital and Research Institute, Velammal Village, Airport ring road, Madurai, Tamilnadu, 625009, India.Department of Cardiology, Velammal Medical College Hospital and Research Institute, Velammal Village, Airport ring road, Madurai, Tamilnadu, 625009, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32623624

Citation

Ponnusamy, Shunmuga Sundaram, et al. "Mid-term Feasibility, Safety and Outcomes of Left Bundle Branch Pacing-single Center Experience." Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing, 2020.
Ponnusamy SS, Muthu G, Kumar M, et al. Mid-term feasibility, safety and outcomes of left bundle branch pacing-single center experience. J Interv Card Electrophysiol. 2020.
Ponnusamy, S. S., Muthu, G., Kumar, M., Bopanna, D., Anand, V., & Kumar, S. (2020). Mid-term feasibility, safety and outcomes of left bundle branch pacing-single center experience. Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing. https://doi.org/10.1007/s10840-020-00807-w
Ponnusamy SS, et al. Mid-term Feasibility, Safety and Outcomes of Left Bundle Branch Pacing-single Center Experience. J Interv Card Electrophysiol. 2020 Jul 4; PubMed PMID: 32623624.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mid-term feasibility, safety and outcomes of left bundle branch pacing-single center experience. AU - Ponnusamy,Shunmuga Sundaram, AU - Muthu,Giridhar, AU - Kumar,Mahesh, AU - Bopanna,Dasarath, AU - Anand,Vijesh, AU - Kumar,Surya, Y1 - 2020/07/04/ PY - 2020/04/28/received PY - 2020/06/22/accepted PY - 2020/7/6/entrez PY - 2020/7/6/pubmed PY - 2020/7/6/medline KW - AV block KW - Heart failure KW - Left bundle pacing KW - Left ventricular activation time KW - Physiological pacing JF - Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing JO - J Interv Card Electrophysiol N2 - BACKGROUND: His bundle pacing (HBP) has evolved as the most physiological form of pacing but associated with limitations. Recently, left bundle branch pacing (LBBP) is emerging as an effective alternative strategy for HBP. OBJECTIVES: Our study was designed to assess the feasibility, efficacy, electrophysiological parameters, and mid-term outcomes of LBBP in Indian population. METHODS: All patients requiring permanent pacemaker implantation for symptomatic bradycardia and heart failure were prospectively enrolled. Echocardiography, QRS duration, pacing parameters, left bundle (LB) potentials, paced QRS duration, and peak left ventricular activation time (pLVAT) were recorded. RESULTS: LBBP was successful in 93 out of 99 patients (94% acute success). Mean age was 62.6 ± 13 years, male 59%, diabetes 69%, and coronary artery disease 65%. Follow-up duration was 4.8 months (range1-12 months). Indication for pacing included atrioventricular (AV) block 43%, cardiac resynchronization therapy 44%, and AV node ablation 4%. LB potential was noted in 37 patients (40%). QRS duration reduced from 144.38 ± 34.6 at baseline to 110.8 ± 12.4 ms after LBBP (p < 0.0001). Pacing threshold was 0.59 ± 0.22 V and sensed R wave 14.14 ± 7.19 mV, and it remained stable during follow-up. Lead depth in the septum was 9.62 mm. LV ejection fraction increased from 44.96 to 53.3% after LBBP (p < 0.0001). One died due to respiratory tract infection on follow up. CONCLUSION: LBBP is a safe and effective strategy (94% acute success) of physiological pacing. The pacing parameters remained stable over a period of 12 months follow-up. LBBP can effectively overcome the limitations of HBP. SN - 1572-8595 UR - https://www.unboundmedicine.com/medline/citation/32623624/Mid-term_feasibility,_safety_and_outcomes_of_left_bundle_branch_pacing-single_center_experience L2 - https://doi.org/10.1007/s10840-020-00807-w DB - PRIME DP - Unbound Medicine ER -
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