Left Bundle Branch Pacing for Cardiac Resynchronization Therapy: Nonrandomized On-Treatment Comparison With His Bundle Pacing and Biventricular Pacing

Wu, Shengjie; Su, Lan; Vijayaraman, Pugazhendhi; Zheng, Rujie; Cai, Mengxing; Xu, Lei; Shi, Ruiyu; Huang, Zhouqing; Whinnett, Zachary I.; Huang, Weijian

doi:10.1016/j.cjca.2020.04.037

Cited by 226 publications

(360 citation statements)

References 25 publications

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“…Direct left bundle branch pacing has become a subject of interest as a novel means for ventricular stimulation and possibly cardiac resynchronization therapy 5 . Certain technical characteristics of this method may be complimentary to His bundle pacing.…”

Section: Resultsmentioning

confidence: 99%

Direct left bundle branch pacing can result in dyssynchronous left ventricular contraction and worsening heart failure: a case report

Chemchirian

Orlov

Maysky

et al. 2020

Preprint

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A 69 year old male patient with mild non ischemic cardiomyopathy, baseline EF of 47%, received a dual chamber pacemaker with a direct left bundle branch lead for complete heart block. 3830 lead was inserted intraseptally according to published recommendations with a resultant QRS of 103 ms. One month later patient presented with severe heart failure. Echocardiogram showed significant dyssynchrony and EF of 21%. Patient remained highly symptomatic despite aggressive medical therapy and exclusion of other causes of heart failure. An upgrade to a bi-ventricular pacing system was performed. At 1 month follow up, patient was no longer exhibiting heart failure symptoms, EF had improved back to baseline (46%) with improvement in dyssynchrony.

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Section: Resultsmentioning

confidence: 99%

Direct left bundle branch pacing can result in dyssynchronous left ventricular contraction and worsening heart failure: a case report

Chemchirian

Orlov

Maysky

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Additionally, recent developments in CRT therapy like His‐bundle or left‐bundle‐branch‐pacing demonstrated superior resynchronization and a trend toward higher echocardiographic response than biventricular CRT 24,25 . Such newer CRT techniques may have an improved impact on sinus rhythm stability.…”

Section: Discussionmentioning

confidence: 99%

Predictors of rhythm outcomes after cardiac resynchronization therapy in atrial fibrillation patients: When should we use an atrial lead?

Nedios

Doering

Darma

et al. 2020

Clinical Cardiology

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Background Cardiac resynchronization therapy (CRT) is widely used in atrial fibrillation (AF) patients and could impact rhythm stability. Hypothesis We aimed to identify predictors of sinus rhythm (SR) stability or AF progression in a real‐word cohort of CRT‐AF patients. Methods From 330 consecutive implantable cardioverter‐defibrillator implantations due to ischemic or dilated cardiomyopathy, 65 (20%) patients with AF history (paroxysmal, n = 32) underwent a CRT implantation with an atrial electrode and were regularly followed every 4–6 months. Rhythm restoration was attempted for most AF patients based on symptoms, biventricular pacing (BP), and lack of thrombi. Results After 33 months, 18 (28%) patients progressed to permanent mode switch (MS≥99%) and 20 (31%) patients had stable SR (MS < 1%). Logistic regression showed that history of persistent AF (OR: 8.01, 95%CI: 2.0–31.7, p = .003) is associated with higher risk of permanent MS. In persistent AF patients, a bigger left atrium (OR: 1.2 per mm, 95%CI: 1.03–1.4, p = .025) and older age (OR: 1.15 per life‐year, 95%CI: 1.01–1.3, p = .032) were predictors of future permanent MS. Paroxysmal AF at implantation (OR: 5.96, 95%CI: 1.6–21.9, p = .007) and increased BP (OR: 1.4 per 1%, 95%CI: 1.05–1.89, p = .02) were associated with stable SR. In persistent AF patients, stable SR correlated with higher BP (98 ± 2 vs. 92 ± 8%, p < .001). Conclusion In patients with AF undergoing CRT implantation, persistent AF, LA dilatation and advanced age relate to future permanent MS (AF), whereas high BP promotes SR stability. These findings could facilitate the management of CRT‐AF patients and guide therapy in order to maximize its effect on rhythm.

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“… 6 Its main advantage over HBP is the low capture threshold. Wu and colleagues 7 compared HBP, LBBAP, and biventricular pacing in 137 candidates for CRT, finding that LBBAP and HBP achieved similar improvement rates in LVEF and functional class (both superior to biventricular pacing) but that LBBAP had a lower threshold (0.49 V vs 1.35 V) and higher R-wave amplitude (11.2 mV vs 3.8 mV). In addition, HBP has been associated with an elevated rate of lead displacement.…”

Section: Discussionmentioning

confidence: 99%

Left bundle branch area pacing after His bundle pacing for cardiac resynchronization in a patient with dextrocardia

Molina-Lerma

Tercedor-Sánchez

Macías-Ruiz

et al. 2020

HeartRhythm Case Reports

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Left Bundle Branch Pacing for Cardiac Resynchronization Therapy: Nonrandomized On-Treatment Comparison With His Bundle Pacing and Biventricular Pacing

Cited by 226 publications

References 25 publications

Direct left bundle branch pacing can result in dyssynchronous left ventricular contraction and worsening heart failure: a case report

Direct left bundle branch pacing can result in dyssynchronous left ventricular contraction and worsening heart failure: a case report

Predictors of rhythm outcomes after cardiac resynchronization therapy in atrial fibrillation patients: When should we use an atrial lead?

Left bundle branch area pacing after His bundle pacing for cardiac resynchronization in a patient with dextrocardia

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