DURABILITY OF LEFT BUNDLE BRANCH AREA PACING.
BACKGROUND: Left bundle branch area pacing (LBBAP) is a form of conduction system pacing. Long term data on the safety and performance of LBBAP one year post device implantation has not been well described.
METHODS AND RESULTS: Sixty-five patients (49% females) who received LBBAP for bradycardia indications using the SelectSecure 3830 lead (Medtronic, Minneapolis, MN) were retrospectively evaluated. Clinical variables were examined. Lead parameters were obtained at implant and during regular follow-up. Mean age of patients was 75.7±10.1 years with left ventricular ejection fraction 59.8±10.4%. Indications for pacing were atrioventricular block 55%, sinus node dysfunction 19%, tachy-brady syndrome 15%, atrioventricular node ablation 8%, and bail out CRT 3%. Mean baseline QRS measured 120±38ms, paced QRS duration was 138±22ms. Paced QRS narrowed by 24ms in those with preexisting left bundle branch block (BBB), increased by 1ms in those with preexisting right BBB, and increased by 42ms in those with no BBB. LBBAP threshold at implant was 0.521±0.153V @0.4ms, and increased to 0.654±0.186V at 3 months (+26%), 0.707±0.186 V at 6 months (+36%), and 0.772±0.220V at 12 months (+48%). Patients with left BBB showed the maximum benefit with QRS narrowing 24ms. Pacing impedance remained unchanged with no procedure related complications.
CONCLUSION: LBBAP is a durable form of conduction system pacing with pacing thresholds remaining relatively stable over 12 months post device implantation. Patients with left BBB display the narrowest paced QRS. This article is protected by copyright. All rights reserved.
Published In/Presented At
Mehta NA, Saqi B, Sabzwari SRA, Gupta R, Vyas A, Gordon J, Cossu S, Nazir T, Freudenberger R, Bozorgnia B. DURABILITY OF LEFT BUNDLE BRANCH AREA PACING. J Cardiovasc Electrophysiol. 2022 May 18. doi: 10.1111/jce.15545. Epub ahead of print. PMID: 35586896.
Medicine and Health Sciences
Department of Medicine, Cardiology Division, Fellows and Residents