Left Bundle Branch Area Pacing for Cardiac Resynchronization Therapy in Right Bundle Branch Block: Results From International Lbbap Collaborative Study Group

Vijayaraman, Pugazhendhi; Cano, Óscar; Ponnusamy, Shunmugasundaram; Molina-Lerma, Manuel; Chan, Joseph Yat Sun; Padala, Santosh K.; Sharma, Parikshit S.; Whinnett, Zachary I.; Herweg, Bengt; Upadhyay, Gaurav A.; Subzposh, Faiz A.; Beer, Dominik; Agnieska, Bednarek; Kiełbasa, Grzegorz; Tung, Roderick; Ellenbogen, Kenneth A.; Jastrzębski, Marek

doi:10.1016/s0735-1097(22)01286-4

Cited by 53 publications

(107 citation statements)

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“…Left bundle branch pacing (LBBP) overcomes the limitation of His bundle pacing (HBP) as it provides stable pacing parameters at low capture threshold 1 . Though studies have shown the feasibility of LBBP as an alternative strategy for cardiac resynchronization therapy the long‐term safety of LBBP is yet to be available 2–4 . A prospective study by Su et al, 5 showed stable pacing parameters at mean follow‐up of 2 years.…”

Section: Introductionmentioning

confidence: 99%

Late dislodgement of left bundle branch pacing lead and successful extraction

Ponnusamy

Vijayaraman

2021

Cardiovasc electrophysiol

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A 61-years-old male underwent left bundle branch pacing for nonischemic dilated cardiomyopathy with recurrent heart failure. Left bundle branch pacing (LBBP) resulted in reduction in QRS duration along with improvement in left ventricular ejection fraction (LVEF) to 64% during follow-up. Two years after implantation he had recurrence of symptoms along with decline in LVEF to 51%. Late lead dislodgement was diagnosed and re-do LBBP was planned. The lead was extracted enmasse without complication and a new 3830 lead was positioned deep inside the proximal septum to capture the left bundle. Postprocedure echocardiography showed no ventricular septal defect or damage to tricuspid leaflet.

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Section: Introductionmentioning

confidence: 99%

Late dislodgement of left bundle branch pacing lead and successful extraction

Ponnusamy

Vijayaraman

2021

Cardiovasc electrophysiol

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“…And in 2020, Guo et al ( 12 ) made a comparison between LBBAP and biventricular pacing (BIV) and the study showed that LBBAP could restore electrical synchrony better and achieve greater improvement in echocardiographic and clinical outcomes. We can take LBBAP to be a feasible treatment as a rescue pacing method or as the primary pacing strategy for HF patients with CRT indications ( 13 , 31 ).…”

Section: Discussionmentioning

confidence: 99%

“…A large single center study ( 11 ), which included 632 patients who underwent left bundle branch area pacing (LBBAP), demonstrated that LBBAP was feasible and safe with high success rate in bradycardia or HF patients during long-term follow-up. And several studies ( 12 , 13 ) have proved that LBBAP could achieve narrowing of QRS duration and improvement of clinical and echocardiographic outcomes in HF patients with LBBB, which means that LBBAP could be a promising resynchronization therapy alternative to biventricular pacing (BVP) for patients with CRT-indications. Since LBBAP is more convenient and cheaper compared to CRT, it would be of clinical interest whether LBBAP could benefit for the HF patients with LBBB and LVEF > 35%.…”

Section: Introductionmentioning

confidence: 99%

Clinical Outcomes of Permanent Left Bundle Branch Area Pacing in Patients With Left Bundle Branch Block and Left Ventricular Ejection Fraction >35 vs. ≤35%

Jiang

et al. 2022

Front. Cardiovasc. Med.

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AimsThe present study aimed to compare the effects of left bundle branch area pacing (LBBAP) on cardiac function and clinical outcomes in patients with left bundle branch block (LBBB) and left ventricular ejection fraction (LVEF) >35 vs. ≤35%.Methods and ResultsThirty-six consecutive patients with LBBB and LVEF <50% were enrolled. All patients were followed up for a mean of 6 months. The successful LBBAP was defined as a paced QRS complex presented as right bundle branch block (RBBB) morphology and QRSd < 130 ms. Echocardiography parameters, pacing parameters and clinical outcomes were collected. The successful LBBAP was achieved in 77.8% of all cases (28/36). In LVEF > 35% group (70 ± 8 years, 9 male), the success rate was 81.0% (17/21). QRSd significantly decreased from 174 ± 23 ms to 108 ± 13 ms (P < 0.001). The pacing threshold and R-wave amplitude were 0.6 ± 0.2 V @ 0.5 ms and 12 ± 7 mV, respectively. In LVEF ≤ 35% group (69 ± 5 years, 9 male), the success rate was 73.3% (11/15) with QRSd decreasing from 188 ± 25 ms to 107 ± 11 ms (P < 0.001). The hyperresponders to LBBAP (functional recovery and LVEF ≥ 50%) in LVEF > 35% group was 52.9%, which were almost twice of that in LVEF ≤ 35% group (33.3%). Whether patients had LBBAP or left ventricular septal pacing (LVSP), patients in the LVEF > 35% group showed significantly lower incidence of heart failure hospitalizations or death from any cause (hazard ratio in LVEF > 35% group, 0.22; 95%CI, 0.06 to 0.75, P = 0.011).ConclusionsLBBAP can significantly shorten the QRSd and improve cardiac function in LBBB patients with either LVEF > 35 or ≤ 35%. LBBAP should be considered as an effective therapy for preventing the deterioration of cardiac function in early-stage heart failure patients with LBBB and LVEF > 35%.

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“…It may be currently considered as a serious alternative to CRT for patients with heart failure and reduced ejection fraction and left bundle branch block (LBBB) or to avoid chronic pacing complications. 3,4 LBBAP leads also provide excellent sensing allowing ventricular arrhythmias detection. In case of nonresponse, there is still the possibility to upgrade the device to a left bundle branch-optimized CRT as described in LOT-CRT study.…”

Section: Case-reportmentioning

confidence: 99%

Physiological pacing with a DF‐1 single chamber defibrillator in a patient with permanent atrial fibrillation and heart block: A case report

Nasarre

Clémenty

Bodin

et al. 2022

Cardiovasc electrophysiol

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We report a case report of a 68-year-old man with chemotherapy-induced cardiomyopathy and uncontrolled permanent atrial fibrillation. Cardiac resynchronization therapy implantation and atrioventricular junction ablation were planned. DF-1 single chamber defibrillator was connected to lead's defibrillation and a lead destinated to left bundle branch area pacing. This system leads to reduce costs by one-third, improve battery longevity, and provide a more physiological pacing.

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Left Bundle Branch Area Pacing for Cardiac Resynchronization Therapy in Right Bundle Branch Block: Results From International Lbbap Collaborative Study Group

Cited by 53 publications

References 0 publications

Late dislodgement of left bundle branch pacing lead and successful extraction

Late dislodgement of left bundle branch pacing lead and successful extraction

Clinical Outcomes of Permanent Left Bundle Branch Area Pacing in Patients With Left Bundle Branch Block and Left Ventricular Ejection Fraction >35 vs. ≤35%

Physiological pacing with a DF‐1 single chamber defibrillator in a patient with permanent atrial fibrillation and heart block: A case report

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