左束支区域起搏可改善右束支阻滞的心电图表现

目的:旨在观察左束支区域起搏(LBBAP)纠正右束支阻滞(RBBB)的临床效果及心电图特点.方法:本研究为单中心、前瞻性观察性研究,纳入2018年4月至2019年12月间入院有心室起搏指征,存在基线RBBB图形且QRS波群时限≥120 ms、左心室射血分数>50％并接受LBBAP的患者,分析LBBAP纠正RBBB的临床...

Impact of Left Bundle Branch Area Pacing on Clinical and Electrocardiogram Characteristics Among Bradycardia Patients With Right Bundle Branch Block

Objectives:Left bundle branch area pacing(LBBAP)has emerged as a feasible physiological pacing form for correction of left bundle branch block(LBBB).Few data are available on effect of LBBAP on clinical and electrocardiogram characteristics in patients with RBBB.Methods:This is a single center,prospective observational study.Consecutive patients with RBBB pattern and QRS duration(QRSd)≥120 ms were enrolled if they underwent LBBAP from April 2018 to December 2019 and left ventricular ejection fraction(LVEF)was>50%.Clinical characteristics,implant pacing parameters,and electrocardiographic morphologies at baseline and after LBBAP were assessed.Results:A total of 33 patients were included,the mean age was(63.6±10.5)years old and average QRSd was(142.9±12.1)ms.LBBAP was successful in 30 patients(90.9%)with significant narrowing of QRSd from(142.9±12.1)ms to(118.2±10.3)ms(P<0.001).The RBBB was completely corrected in 60.6%patients(20/33)with post-LBBAP QRSd<120 ms and partially corrected in 33.3%patients(11/33)with post-LBBAP QRSd≥120 ms.Four forms of QRS morphologies in lead V1 were observed after LBBAP,including Qr(48.4%),QR(22.6%),qR(19.4%)and QS(9.7%)patterns.Complete RBBB correction was more likely to be achieved by LBBAP in patients with QRS morphology of qR pattern at baseline.Conclusions:LBBAP could effectively correct RBBB and narrow QRSd in patients with RBBB.LBBAP could effectivly correct RBBB,complete RBBB correction was more likely to be achieved by LBBAP in patients with QRS morphology of qR pattern at baseline.