Rescue left bundle branch area pacing in coronary venous lead failure or nonresponse to biventricular pacing: Results from International LBBAP Collaborative Study Group
Jazyk angličtina Země Spojené státy americké Médium print-electronic
Typ dokumentu časopisecké články
PubMed
35504539
DOI
10.1016/j.hrthm.2022.04.024
PII: S1547-5271(22)01948-8
Knihovny.cz E-zdroje
- Klíčová slova
- Biventricular pacing failure, Cardiac resynchronization therapy, Heart failure, Left bundle branch area pacing, Nonresponder,
- MeSH
- blokáda Tawarova raménka diagnóza etiologie terapie MeSH
- elektrokardiografie metody MeSH
- funkce levé komory srdeční fyziologie MeSH
- Hisův svazek MeSH
- kardiostimulace umělá metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- srdeční arytmie terapie MeSH
- srdeční resynchronizační terapie * metody MeSH
- srdeční selhání * diagnóza etiologie terapie MeSH
- tepový objem MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Cardiac resynchronization therapy (CRT) using biventricular pacing (BVP) is effective in patients with heart failure, left bundle branch block (LBBB), and reduced left ventricular function. Left bundle branch area pacing (LBBAP) has been reported as an alternative option for CRT. OBJECTIVE: The purpose of this study was to assess the feasibility and outcomes of LBBAP in patients who failed conventional BVP because of coronary venous (CV) lead complications or who were nonresponders to BVP. METHODS: At 16 international centers, LBBAP was attempted in patients with conventional CRT indication who failed BVP because of CV lead complications or lack of therapeutic response to BVP. Heart failure hospitalization (HFH) and death, echocardiographic outcomes, procedural data, pacing parameters, and lead complications including CV lead failure are reported. RESULTS: LBBAP was successfully performed in 200 patients (CV lead failures 156; nonresponders 44) (age 68 ± 11 years; female 35%; LBBB 55%; right ventricular pacing 23%; ischemic cardiomyopathy 28%; nonischemic cardiomyopathy 63%; left ventricular ejection fraction [LVEF] ≤35% in 80%). Procedural duration was 119.5 ± 59.6 minutes, and fluoroscopy duration was 25.7 ± 18.5 minutes. LBBAP threshold and R-wave amplitudes were 0.68 ± 0.35 V @ 0.45 ms and 10.4 ± 5 mV at implant, respectively, and remained stable during mean follow-up of 12 ± 10.1 months. LBBAP resulted in significant QRS narrowing from 170 ± 28 ms to 139 ± 25 ms (P <.001) with V6 R-wave peak times of 85 ± 17 ms. LVEF improved from 29% ± 10% at baseline to 40% ± 12% (P <.001) during follow-up. The risk of death or HFH was lower in those with CV lead failure than in nonresponders (hazard ratio 0.357; 95% confidence interval 0.168-0.756; P = .007) CONCLUSION: LBBAP is a viable alternative to CRT in patients who failed conventional BVP due to CV lead failure or who were nonresponders.
Department of Cardiology Cardiovascular Research Institute Maastricht Maastricht The Netherlands
Department of Cardiology Catharina Ziekenhuis Eindhoven The Netherlands
Department of Cardiology University Hospital Antwerp Belgium
Division of Cardiology University of South Florida Tampa Florida
Electrophysiology Unit Department of Cardiology Aster Medcity Kochi Kerala India
Geisinger Heart Institute Wilkes Barre Pennsylvania
Rush University Medical Center Chicago Illinois
South Lake Regional Health Center University of Toronto Toronto Canada
University of Chicago Chicago Illinois
Virgen de las Nieves Hospital Granada Spain
Virginia Commonwealth University Health System Richmond Virginia
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