LBBAP in patients with normal intrinsic QRS duration: Electrical and mechanical characteristics

Abstract

Background Left bundle branch area pacing (LBBAP) is an innovative pacing technology, which needs further study. Methods Seventy LBBAP patients with intrinsic QRS duration (QRSd) less than 120 ms were consecutively enrolled in our center. According to whether the left bundle branch potential (LBBp) was recorded or not, the patients were divided into the potential positive group (LBBAP+) and the potential negative group (LBBAP−). Electrocardiographic and echocardiographic parameters were used to evaluate electrical and mechanical characteristics. Lead parameters and complications were followed‐up. Results There were 52 patients in LBBAP+ and 18 patients in LBBAP−. The QRSd and the left ventricular activation time (LVAT) were wider after LBBAP. QRSd showed no significant difference between LBBAP+ and LBBAP−. LVAT was significantly shorter in LBBAP+ than in LBBAP−. Frontal QRS axis shifted leftward and the V1 morphologies changed after LBBAP. QRS axis and V1 morphologies showed no significant differences between two groups. Paced R‐wave transition moved forward compared with intrinsic R‐wave transition in both groups. Peak systolic strain of left ventricle (LVPSS) increased, and peak systolic dispersion of left ventricle (LVPSD) did not change significantly after LBBAP. Systolic and diastolic function as well as mechanical synchronism had no significant differences between two groups. LBBAP had great pacing parameters. Conclusion LBBAP changes electrical and mechanical characteristics and has good safety in patients with normal intrinsic QRSd. LBBAP+ and LBBAP− show no significant differences in mechanical synchronization and interventricular electrical synchronization. The LBBAP+ shows better left ventricular electrical synchronicity.

Comparison of efficacy of left bundle branch area pacing and biventricular pacing in patients with dilated cardiomyopathy

“…From our research, we can see that LBBAP has a more obvious role in reverse remodeling of cardiac structure than BIVP and can signi cantly reduce LAD and LVIDD. Therefore, the advantages of LBBAP may be related to its ability to provide more physiological ventricular activation modes, generate better electrical and mechanical resynchronization [26][27][28][29] , and may have bene cial effects on left atrial function by reducing LAD in patients with high ventricular pacing load. In contrast, the left ventricular electrode of BIVP reaches the epicardium of the left ventricle through the target vein.…”