TY - JOUR
T1 - Left bundle branch pacing vs ventricular septal pacing for cardiac resynchronization therapy
AU - Chen, Jingjing
AU - Ezzeddine, Fatima M.
AU - Liu, Xiaoke
AU - Vaidya, Vaibhav
AU - McLeod, Christopher J.
AU - Valverde, Arturo M.
AU - Del-Carpio Munoz, Freddy
AU - Deshmukh, Abhishek J.
AU - Madhavan, Malini
AU - Killu, Ammar M.
AU - Mulpuru, Siva K.
AU - Friedman, Paul A.
AU - Cha, Yong Mei
N1 - Publisher Copyright:
© 2024 Heart Rhythm Society
PY - 2024/3
Y1 - 2024/3
N2 - Background: The outcomes of left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP) in patients with heart failure remain to be learned. Objective: The objective of this study was to assess the echocardiographic and clinical outcomes of LBBP, LVSP, and deep septal pacing (DSP). Methods: This retrospective study included patients who met the criteria for cardiac resynchronization therapy (CRT) and underwent attempted LBBP in 5 Mayo centers. Clinical, electrocardiographic, and echocardiographic data were collected at baseline and follow-up. Results: A total of 91 consecutive patients were included in the study. A total of 52 patients had LBBP, 25 had LVSP, and 14 had DSP. The median follow-up duration was 307 (interquartile range 208, 508) days. There was significant left ventricular ejection fraction (LVEF) improvement in the LBBP and LVSP groups (from 35.9 ± 8.5% to 46.9 ± 10.0%, P < .001 in the LBBP group; from 33.1 ± 7.5% to 41.8 ± 10.8%, P < .001 in the LVSP group) but not in the DSP group. A unipolar paced right bundle branch block morphology during the procedure in lead V1 was associated with higher odds of CRT response. There was no significant difference in heart failure hospitalization and all-cause deaths between the LBBP and LVSP groups. The rate of heart failure hospitalization and all-cause deaths were increased in the DSP group compared with the LBBP group (hazard ratio 5.10, 95% confidence interval 1.14–22.78, P = .033; and hazard ratio 7.83, 95% confidence interval 1.38–44.32, P = .020, respectively). Conclusion: In patients undergoing CRT, LVSP had comparable CRT outcomes compared with LBBP.
AB - Background: The outcomes of left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP) in patients with heart failure remain to be learned. Objective: The objective of this study was to assess the echocardiographic and clinical outcomes of LBBP, LVSP, and deep septal pacing (DSP). Methods: This retrospective study included patients who met the criteria for cardiac resynchronization therapy (CRT) and underwent attempted LBBP in 5 Mayo centers. Clinical, electrocardiographic, and echocardiographic data were collected at baseline and follow-up. Results: A total of 91 consecutive patients were included in the study. A total of 52 patients had LBBP, 25 had LVSP, and 14 had DSP. The median follow-up duration was 307 (interquartile range 208, 508) days. There was significant left ventricular ejection fraction (LVEF) improvement in the LBBP and LVSP groups (from 35.9 ± 8.5% to 46.9 ± 10.0%, P < .001 in the LBBP group; from 33.1 ± 7.5% to 41.8 ± 10.8%, P < .001 in the LVSP group) but not in the DSP group. A unipolar paced right bundle branch block morphology during the procedure in lead V1 was associated with higher odds of CRT response. There was no significant difference in heart failure hospitalization and all-cause deaths between the LBBP and LVSP groups. The rate of heart failure hospitalization and all-cause deaths were increased in the DSP group compared with the LBBP group (hazard ratio 5.10, 95% confidence interval 1.14–22.78, P = .033; and hazard ratio 7.83, 95% confidence interval 1.38–44.32, P = .020, respectively). Conclusion: In patients undergoing CRT, LVSP had comparable CRT outcomes compared with LBBP.
KW - Cardiac resynchronization therapy
KW - Deep septal pacing
KW - Heart failure
KW - Left bundle branch pacing
KW - Left ventricular septal pacing
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U2 - 10.1016/j.hroo.2024.01.005
DO - 10.1016/j.hroo.2024.01.005
M3 - Article
AN - SCOPUS:85186188404
SN - 2666-5018
VL - 5
SP - 150
EP - 157
JO - Heart Rhythm O2
JF - Heart Rhythm O2
IS - 3
ER -