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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
Author(s) -
Wang Yao,
Gu Kai,
Qian Zhiyong,
Hou Xiaofeng,
Chen Xing,
Qiu Yuanhao,
Jiang Zeyu,
Zhang Xinwei,
Wu Hongping,
Chen Minglong,
Zou Jiangang
Publication year - 2020
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14628
Subject(s) - medicine , cardiology , ejection fraction , cardiac resynchronization therapy , left bundle branch block , qrs complex , heart failure , bundle branch block , cardiac function curve , electrocardiography
Background Left bundle branch area pacing (LBBAP) was reported to improve cardiac function by correcting complete left bundle branch block (CLBBB). Our study aimed to compare the efficacy of LBBAP and biventricular pacing (BIVP) in heart failure patients with CLBBB. Methods Ten patients prospectively underwent LBBAP (LBB‐CRT group) and 30 patients received BIVP (BIV‐CRT group) were matched using propensity score matching. LBBAP was achieved by the trans‐interventricular septum method. Echocardiography, electrocardiogram, NYHA classification, and blood B‐type natriuretic peptide concentration were evaluated at preimplantation and at 6‐month follow up. CRT response was defined as at least 15% decrease in left ventricular end‐systolic volume. Results In the LBB‐CRT group, CLBBB were successfully corrected by LBBAP with no complications. QRS duration (QRSd) significantly decreased after implantation in both groups, and the decrease of QRSd in the LBB‐CRT group was significantly greater than that in the BIV‐CRT group (60.80 ± 20.09 vs. 33.00 ± 21.48 ms, p = .0009). The echocardiographic measurements including left ventricular end‐diastolic diameter, left ventricular end‐systolic diameter, and left ventricular ejection fraction significantly improved after 6 months in both groups. The response rate was significantly higher in LBB‐CRT group than BIV‐CRT group (100.00% vs. 63.33%, p = .038). The percentage of patients in New York Heart Association classification Grades I and II was significantly higher in the LBB‐CRT group compared with that in the BIV‐CRT group (median 1.5 vs. 2.0, p = .029) at 6‐month follow‐up. Conclusions It is effective and safe to correct CLBBB with LBBAP in heart failure patients. Compared with BIVP, LBBAP can better optimize electrical synchrony and improve cardiac function.