Simplifying Physiological Left Bundle Branch Area Pacing Using a New Nine-Partition Method

Zhang, Junmeng; Wang, Zefeng; Zu, Linna; Cheng, Liao‐Ping; Su, Ruijuan; Wang, Xinlu; Liang, Zhuo; Chen, Jieruo; Hang, Fei; Du, Jie; Huang, Weijian; Wu, Yongquan

doi:10.1016/j.cjca.2020.05.011

Cited by 65 publications

(63 citation statements)

References 18 publications

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“…Then, correlation and regression analyses showed that only the number of attempts was an independent factor related to the change of troponin T. Therefore, achieving success with the least number of attempts is an effective way to reduce myocardial damage. The previous studies have pointed out that the ventricular nine partition method 17 and typical bundle branch block morphology 18 are effective to predict the success of LBBAP. Besides, intracardiac echocardiogram was an efficient tool to guide LB-BAP 19 .…”

Section: Discussionmentioning

confidence: 99%

Quantification of Acute Myocardial Damage Secondary to Implantation of Electrodes for the Left Bundle Branch Area Pacing

Chen

et al. 2021

RIC

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Background: Different from the traditional right ventricular pacing, the left bundle branch area pacing (LBBAP) is accomplished with deeper lead implantation and more attempts. However, myocardial damage is unclear in LBBAP. Objective: The objective of the study was to observe the change of troponin T and explore possible factors associated with greater myocardial damage in LBBAP. Methods: Patients with an indication for pacemaker implantation underwent attempts for LBBAP by transventricular septal method. Levels of troponin T were determined before operation, 12 h and 1 week after the operation. Parameters of intraoperation and follow-up were recorded and analyzed. Results: In total, successful LBBAP was achieved in 126 patients. The levels of troponin T increased significantly at 12 h after the operation compared with those before operation (96.45 ± 11.07 [69.06] vs. 16.59 ± 1.84 [11.92] ng/L, p < 0.001), while there were no significant differences between pre-and post-operative levels at 1 week. Correlation and regression analysis showed that only the number of attempts was an independent factor related to the change of troponin T. During 1 year of follow-up, LBBAP was safe and feasible with few complications. Conclusions: Myocardial damage of LBBAP was clinically significant. The number of attempts was an independent factor related to the myocardial damage. (REV INVEST CLIN. [AHEAD OF PRINT]

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Section: Discussionmentioning

confidence: 99%

Quantification of Acute Myocardial Damage Secondary to Implantation of Electrodes for the Left Bundle Branch Area Pacing

Chen

et al. 2021

RIC

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“…The LBBaP lead will be implanted by 'New Nine Partition Method', details of the implantation technique have been discussed in an article written by our team. 17 During the procedure, lead V1 signal is monitored by one bedside patient monitor. Lead V of the monitor is affixed to the V1 position for 12-lead ECGs.…”

Section: Lbbap Group Implantation Methodsmentioning

confidence: 99%

Efficacy and safety of left bundle branch area pacing versus biventricular pacing in heart failure patients with left bundle branch block: study protocol for a randomised controlled trial

et al. 2020

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IntroductionLeft bundle branch area pacing (LBBaP) has been accepted as a physiological pacing method that can yield narrow paced QRS waves. For patients with failed biventricular pacing (Bi-V), LBBaP is another feasible option. However, no randomised controlled study has evaluated the efficacy and safety of LBBaP in heart failure patients with left bundle branch block (LBBB). Therefore, we aimed to conduct this type of randomised controlled trial.Methods and analysisThis study is a single-centre, randomised controlled non-inferiority trial. This study will be conducted at the cardiac centre of Beijing Anzhen Hospital. From January 2020 to December 2022, 180 heart failure patients with reduced left ventricular ejection fraction (LVEF ≤35%) and LBBB undergoing Bi-V implantation will be consecutively enrolled in this study. Participants will be randomised at a 1:1 ratio into an experimental group (LBBaP) and a control group (Bi-V). The primary outcome is LVEF. The secondary outcomes are NT-proBNP, duration of the QRS complex, end systolic volume, end diastolic volume, the 6-minute walking test and quality of life (SF-36 scale), all causes of mortality, cardiovascular death, rehospitalisation rate of heart failure, other rehospitalisation rates, major complication rates, procedure costs and hospitalised dates.Ethics and disseminationThis study has been approved by the Beijing Anzhen Hospital Medical Ethics Committee (No. ks201932). The results of this study will be presented at domestic and international conferences. We hypothesise that LBBaP is non-inferior compared with Bi-V for treating patients with heart failure and LBBB. This trial will provide evidence-based recommendations for electrophysiologists.Trial registration numberChinese Clinical Trial Registry (ChiCTR2000028726).

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“…The results at 1-year follow-up showed that the duration of QRS was narrow, the pacing threshold was low, the parameters (voltage, sensing and impedance)were stable, and there were no surgical complications such as lead dislocation, lead infection or stroke. 11 Furthermore, our Centre has completed a study that contrasts LBBaP and RVAP in patients with atrioventricular block (AVB) and normal cardiac function. 12 Recent follow-up has shown that LBBaP can improve left ventricular synchronisation and cardiac function.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of left bundle branch area pacing versus right ventricular apex pacing in patients with atrioventricular block: study protocol for a randomised controlled trial

Wang¹,

Du²,

Cheng³

et al. 2021

BMJ Open

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IntroductionLeft bundle branch area pacing (LBBaP) is a relatively new approach for physiologic pacing. A limited number of retrospective clinical studies, featuring small sample sizes, have shown that compared with right ventricular apex pacing (RVAP), the QRS duration of postoperative ECG in LBBaP patients is narrower and the cardiac systolic function is improved. However, there have been no randomised controlled trials (RCTs) evaluating the efficacy and safety of LBBaP in patients with atrioventricular block (AVB). Therefore, the current study intends to address the paucity in RCT data evaluating LBBaP versus RVAP in AVB patients.Analysis and methodsThis study is a single-centre, randomised controlled superiority trial to be conducted at the Cardiac Centre of Beijing Anzhen Hospital. From January 2021 to December 2023, 210 consecutive AVB patients meeting the inclusion criteria and receiving pacemaker implantation will be enrolled. Participants will be randomly divided into an experimental group (LBBaP) and a control group (RVAP) at a 1:1 ratio. The primary outcome is left ventricular ejection fraction (LVEF), which will be assessed by echocardiography. The secondary outcomes in this study are synchrony of left ventricular systole, NT-proBNP, LVEDD, the 6-min walk distance, quality of life (SF-36 scale), all-cause mortality, cardiovascular death events, rehospitalisation rate and major complication rate.Ethics and disseminationThis study was approved by the Medical Ethics Committee of Beijing Anzhen Hospital (No. 2020021X). The results of the trial will be presented at national and international conferences. We hypothesise that compared with RVAP, LBBaP will be superior for treating patients with AVB. This trial will provide evidence-based suggestion for the majority of electrophysiologists in pacing implantation.Trial registrationChiCTR2000034335.

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Simplifying Physiological Left Bundle Branch Area Pacing Using a New Nine-Partition Method

Cited by 65 publications

References 18 publications

Quantification of Acute Myocardial Damage Secondary to Implantation of Electrodes for the Left Bundle Branch Area Pacing

Quantification of Acute Myocardial Damage Secondary to Implantation of Electrodes for the Left Bundle Branch Area Pacing

Efficacy and safety of left bundle branch area pacing versus biventricular pacing in heart failure patients with left bundle branch block: study protocol for a randomised controlled trial

Efficacy and safety of left bundle branch area pacing versus right ventricular apex pacing in patients with atrioventricular block: study protocol for a randomised controlled trial

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