Left bundle branch area pacing delivery of cardiac resynchronization therapy and comparison with biventricular pacing

Li, Xiaofei; Qiu, Chunguang; Xie, Ruiqin; Ma, Wentao; Wang, Zhao; Li, Hui; Wang, Hao; Hua, Wei; Zhang, Shu; Yao, Yan; Fan, Xiaohan

doi:10.1002/ehf2.12731

Cited by 108 publications

(217 citation statements)

References 21 publications

Supporting

Mentioning

209

Contrasting

Order By: Relevance

“…7,26 Recently, Li et al reported that LBBP-CRT was successful in 81.1% of the heart failure patients with LBBB, and the response rate and super response rate were 88.9% and 44.4%, respectively, which were greater than that of BiV-CRT(66.7% and 16.7%). 27 However, the study wasn't randomizedly designed and the morphological characteristics of LBBB were not strictly defined in their study there may be more patients with"true"LBBB in the LBBP…”

Section: Discussionmentioning

confidence: 99%

Remarkable response to cardiac resynchronization therapy via left bundle branch pacing in patients with true left bundle branch block

Guo

Xiao

et al. 2020

Clinical Cardiology

View full text Add to dashboard Cite

Background: Left bundle branch pacing (LBBP) has been suggested as an alternative means to deliver cardiac resynchronization therapy (CRT). Hypothesis: LBBP may deliver resynchronization therapy along with an advantage over traditional biventricular (BiV) pacing in clinical outcomes. Methods: Heart failure patients who presented LBBB morphology according to Strauss's criteria and received successful CRT procedure were enrolled in the present study. Propensity score matching was applied to match patients into LBBP-CRT group and BiV-CRT group. Then, the electrographic data, the echocardiographic data and New York heart association (NYHA) class were compared between the groups. Results: Twenty-one patients with successful LBBP procedure and another 21 matched patients with successful BiV-CRT procedure were finally enrolled in the study. The QRS duration (QRSd) was narrowed from 167.7 ± 14.9 ms to 111.7 ± 12.3 ms (P < .0001) in the LBBP-CRT group and from 163.6 ± 13.8 ms to 130.1 ± 14.0 ms (P < .0001) in the BiV-CRT group. A trend toward better left ventricular ejection fraction (LVEF) was recorded in the LBBP-CRT group (50.9 ± 10.7% vs 44.4 ± 13.3%, P = .12) compared to that in the BiV-CRT group at the 6-month follow-up. A trend toward better echocardiographic response was documented in patients receiving LBBP-CRT procedure (90.5% vs 80.9%, P = .43) and more super CRT response was documented in the LBBP-CRT group (80.9% vs 57.1%, P = .09) compared to that in the BiV-CRT group. Conclusions: LBBP-CRT can dramatically improve the electrical synchrony in heart failure patients with LBBB. Meanwhile, compared with the traditional BiV-CRT, it has Jincun Guo and Linlin Li contributed equally to this work.

show abstract

Section: Discussionmentioning

confidence: 99%

Remarkable response to cardiac resynchronization therapy via left bundle branch pacing in patients with true left bundle branch block

Guo

Xiao

et al. 2020

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

“…All studies focused on CRT candidates with LBBB and HF who underwent permanent LBBP implantation, including primary implantation, 10,12,13,15 unsuccessful LV lead placement 12 and failure to achieve acceptable HBP parameters 11,14 . In brief, there are two methods 16 to identify the location for LBBP lead placement in six studies: the single lead method 10,12–15 and the dual lead method 11 . After confirming the initial site for LBBP the lead is then advanced deep into the septum to achieve left conduction system capture (Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…The study reported significant shortened QRSd (129.09 ± 15.94 ms from native 180.00 ± 15.86 ms), and all 11 patients had their LVEF improvement by at least 5% of baseline value and 7 patients had an increase in LVEF by more than 20% during follow‐up of mean 6.7 months. In order to evaluate the clinical effects of LBBP against BVP, Li et al 12 . compared 27 patients received LBBP alone to 54 patients with BVP by using two to one propensity score matching to minimize bias based on gender, baseline QRSd, LVEF, and LVEDD.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Left bundle branch pacing for cardiac resynchronization therapy: A systematic literature review and meta‐analysis

Zhong

Shi

et al. 2021

Pacing Clinical Electrophis

View full text Add to dashboard Cite

Background Left bundle branch pacing (LBBP) recently has been suggested as an alternative modality to deliver cardiac resynchronization therapy (CRT). Data on LBBP for CRT are limited to small sample reports, and clinical benefits and risks have not been systematically assessed. We sought to systematically examine published studies of LBBP for CRT and quantify the feasibility and efficacy of the therapy. Methods Cochrane Library, PubMed, Web of Science, and Embase databases were searched from inception to September 30, 2020 to identify relevant studies evaluating LBBP in patients for CRT. Clinical outcomes of interest included implant success rate, QRS duration (QRSd), pacing threshold, left ventricular (LV) function at baseline and follow‐up, heart failure‐related hospitalization, and mortality. Data were extracted and summarized. Results A total of six studies (two single‐arm studies and four comparative studies) involving 174 patients were included. The results showed that the average age of patients was 64.9 years and all were implanted for CRT. The procedural success rate was only reported in two studies (97% and 81.1%, respectively). LBBP resulted in a narrow of mean QRSd from 172.7 ± 4.8 to 115.1 ± 7.6 ms. LV function, including LV ejection fraction and LV end‐diastolic dimension improved at follow‐up. During a mean follow‐up of 8.1 months, 1.3% of patients experienced heart failure‐related hospitalization and no patients died. Conclusion LBBP is a feasible strategy with significant efficacy and safety for CRT candidates.

show abstract

“…There is evident in LV activation time studies where LV activation time is only minimally increased in RBBB but signi cantly increased in LBBB [23]. LOT-CRT advantage narrowing of QRSd in those patients with the baseline surface ECG of atypical LBBB morphology [24]. LOT-CRT offers the advantage to use the LV lead in addition to LBBAP in a potential scenario of progression of conduction disease.…”

Section: Electrophysiological De Nitionmentioning

confidence: 99%

Cardiac Resynchronization Therapy using Left-Bundle-Branch Area and Left Ventricular Pacing

Feng

Yang

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Cardiac resynchronization therapy via biventricular pacing is an established therapy for patients with heart failure. However, high nonresponder rates and inability to predict response remains a challenge. Recently left bundle branch area pacing (LBBAP) has been shown to be feasible and may also improve clinical outcomes. In this article we describe the new technique (sequential LBBAP followed by left ventricular pacing, LOT-CRT) and assess the feasibility of LOT-CRT.Methods: The RV implantation site was positioned and the LBBAP lead was implanted using our methods. The QRS duration (QRSd) at baseline, during LBBAP, biventricular pacing, and LOT-CRT was measured. Results: LOT-CRT was successful in 5 patients (age 71.8 ± 5.1 years, men 3, ischemic 3). The QRSd at baseline was 158.0 ± 13.0 ms and significantly narrowed to 117.0 ± 6.7 ms during LOT-CRT (P < 0.01). During 3-month follow-up, LV ejection fraction improved from 32.8 ± 5.2 % to 45.0 ± 5.1% (P < 0.01), and New York Heart Association functional class changed from 3.25 ± 0.5 to 2.5 ± 0.6 (P < 0.05). A decrease in left ventricular end-diastolic dimension was observed, with widening from (68.2 ± 12.3) mm at baseline to (62.2 ± 11.3) mm at pacing (P < 0.05). The length of operation time was (152.0 ± 31.1) min. Conclusions: The study demonstrates that LOT-CRT is clinically feasible in patients with systolic HF and LBBB. LOT-CRT was associated with significant narrowing of QRSd and improvement in LV function, especially in patients with ischemic cardiomyopathy.

show abstract

Left bundle branch area pacing delivery of cardiac resynchronization therapy and comparison with biventricular pacing

Cited by 108 publications

References 21 publications

Remarkable response to cardiac resynchronization therapy via left bundle branch pacing in patients with true left bundle branch block

Remarkable response to cardiac resynchronization therapy via left bundle branch pacing in patients with true left bundle branch block

Left bundle branch pacing for cardiac resynchronization therapy: A systematic literature review and meta‐analysis

Cardiac Resynchronization Therapy using Left-Bundle-Branch Area and Left Ventricular Pacing

Contact Info

Product

Resources

About