The efficacy of left bundle branch area pacing compared with biventricular pacing in patients with heart failure: A matched case–control study

Wang, Yao; Gu, Kai; Zhang, Qian; Hou, Xiaofeng; Chen, Xing; Qiu, Yuanhao; Jiang, Zeyu; Zhang, Xinwei; Wu, Hongping; Chen, Minglong; Zou, Jiangang

doi:10.1111/jce.14628

Cited by 70 publications

(136 citation statements)

References 28 publications

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“…Of these, 24 studies were excluded due to abstract/review article, case report, and no revelent outcome. Altogether, the remaining six studies [10][11][12][13][14][15] comprising 174 patients were included in the analysis.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…Of all six studies, two were single-arm studies and the remaining four were comparative studies. Each patient had received guidelinedirected medical therapy before undergoing the procedure in the three studies, [11][12][13] and most of patients received that in the other studies. 10,14,15 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.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…Each patient had received guidelinedirected medical therapy before undergoing the procedure in the three studies, [11][12][13] and most of patients received that in the other studies. 10,14,15 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][13][14][15] and the dual lead method.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…10,14,15 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][13][14][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: Study Selection and Characteristicsmentioning

confidence: 99%

“…First, the number of included patients was limited and all included studies were nonrandomized trials, which reduced the internal validity of this modality and made the conclusion of this study less credible. Second, most studies did not include the definition of QRSd for the success of LBBP, 11,[13][14][15] which is related with the correction of electrical conduction disturbance and electromechanical resynchronization. In addition, pacing capture threshold and LVEF follow-up data were not paired, and follow-up times and pacing pulse width were variable and inconsistent by study.…”

Section: Limitationsmentioning

confidence: 99%

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

Zhong

Shi

et al. 2021

Pacing Clinical Electrophis

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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.

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Section: Study Selection and Characteristicsmentioning

confidence: 99%

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

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

Zhong

Shi

et al. 2021

Pacing Clinical Electrophis

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Comparative effects of left bundle branch area pacing, His bundle pacing, biventricular pacing in patients requiring cardiac resynchronization therapy: A network meta‐analysis

Hua

Wang

Kong

et al. 2022

Clinical Cardiology

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Background:The comparative effects of different types of cardiac resynchronization therapy (CRT) delivered by biventricular pacing (BVP), His bundle pacing (HBP), and left bundle branch area pacing (LBBAP) remain inconclusive.Hypothesis: HBP and LBBAP may be advantageous over BVP for CRT.Methods: PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched for studies that reported the effects after BVP, HBP, and LBBAP for CRT. The effects between groups were compared by a frequentist random-effects network meta-analysis (NMA), by which the mean differences (MDs) and 95% confidence intervals (CIs) were calculated.Results: Six articles involving 389 patients remained for the final meta-analysis. The mean follow-up of these studies was 8.03 ± 3.15 months. LBBAP resulted in a greater improvement in LVEF% (MD = 7.17, 95% CI = 4.31 to 10.04), followed by HBP (MD = 4.06, 95% CI = 1.09 to 7.03) compared with BVP. HBP resulted in a narrower QRS duration (MD = 31.58 ms, 95% CI = 12.75 to 50.40), followed by LBBAP (MD = 27.40 ms, 95% CI = 10.81 to 43.99) compared with BVP. No significant differences of changes in LVEF improvement and QRS narrowing were observed between LBBAP and HBP. The pacing threshold of LBBAP was significantly lower than those of BVP and HBP. Conclusion:The NMA first found that LBBAP and HBP resulted in a greater LVEF improvement and a narrower QRS duration compared with BVP. Additionally, LBBAP resulted in similar clinical outcomes but with lower pacing thresholds, and may therefore offer advantages than does HBP for CRT.

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Left bundle branch area pacing in mildly reduced heart failure: A systematic literature review and meta‐analysis

Kim

Cho

et al. 2023

Clinical Cardiology

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Cardiac resynchronization therapy (CRT) strategy for heart failure with mildly reduced ejection fraction (HFmrEF) is controversial. Left bundle branch area pacing (LBBAP) is an emerging pacing modality and an alternative option to CRT. This analysis aimed to perform a systematic review of the literature and meta-analysis on the impact of the LBBAP strategy in HFmrEF, with left ventricular ejection fraction (LVEF) between 35% and 50%. PubMed, Embase, and Cochrane Library were searched for full-text articles on LBBAP from inception to July 17, 2022. The outcomes of interest were QRS duration and LVEF at baseline and follow-up in mid-range heart failure. Data were extracted and summarized. A random-effect model incorporating the potential heterogeneity was used to synthesize the results. Out of 1065 articles, 8 met the inclusion criteria for 211 mid-range heart failure patients with an implant LBBAP across the 16 centers. The average implant success rate with lumenless pacing lead use was 91.3%, and 19 complications were reported among all 211 enrolled patients. During the average follow-up of 9.1 months, the average LVEF was 39.8% at baseline and 50.5% at follow-up (MD: 10.90%, 95% CI: 6.56−15.23, p < .01). Average QRS duration was 152.6 ms at baseline and 119.3 ms at follow-up (MD: −34.51 ms, 95% CI: −60.00 to −9.02, p < .01). LBBAP could significantly reduce QRS duration and improve systolic function in a patient with LVEF between 35% and 50%. Application of LBBAP as a CRT strategy for HFmrEF may be a viable option.

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The efficacy of left bundle branch area pacing compared with biventricular pacing in patients with heart failure: A matched case–control study

Cited by 70 publications

References 28 publications

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

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

Comparative effects of left bundle branch area pacing, His bundle pacing, biventricular pacing in patients requiring cardiac resynchronization therapy: A network meta‐analysis

Left bundle branch area pacing in mildly reduced heart failure: A systematic literature review and meta‐analysis

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