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Cardiac resynchronization performed by LBBaP-CRT in patients with cardiac insufficiency and left bundle branch block
Authors:Linna Zu MD  Zefeng Wang MD  Fei Hang MD  Yang Jiang MD  Xinlu Wang MD  Liting Cheng MD  Junmeng Zhang PhD  Yongquan Wu MD
Affiliation:1. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

Department of Cardiology, Aviation General Hospital, China Medical University, Beijing, China;2. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China;3. Department of Cardiology, Aviation General Hospital, China Medical University, Beijing, China;4. Department of Cardiology, Heart Center, the First Hospital of Tsinghua University, Beijing, China

Abstract:

Objective

To evaluate the efficacy and safety of left bundle branch area pacing (LBBaP) in patients with heart failure and left bundle branch block (LBBB), and to compare the clinical effects with traditional cardiac resynchronization therapy (CRT).

Methods

Thirty-two patients with dilated cardiomyopathy complicated by cardiac insufficiency and left bundle branch block were divided into CRT group and LBBaP group. Parameters including pacing threshold, R-wave amplitude, pacing impedance and operation time, and X-ray exposure time were recorded. The left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD) were examined by echocardiography. The changes of QRS complex before and after operation were compared.

Results

Compared with CRT group, the LBBaP group spent less time on total operation time and X-ray exposure time and had stable electrode parameters including pacing threshold, R-wave amplitude, and lead impedance after 12-month follow-up. In addition, LBBaP can achieve narrow QRS complex (117.15 ± 9.91) ms immediately than that in CRT group (130.32 ± 12.41) ms. The change of QRS between LBBaP is (50.30 ± 23.79) ms and CRT group is (33.15 ± 20.22) ms. After 6 months' follow-up in LBBaP group, EF was higher than that before operation. Followed up for 12 months after operation, EF and LVEDD in LBBaP group were significantly improved compared with those before operation.

Conclusion

Left bundle branch area pacing is a safe and effective resynchronization method for patients with cardiac insufficiency and asynchronization, which can achieve same clinical effects to CRT.
Keywords:cardiac insufficiency  cardiac resynchronization therapy  left bundle branch area pacing  left bundle branch block
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