Result of the Physiologic Pacing Registry, an international multicenter prospective observational study of conduction system pacing
Language English Country United States Media print-electronic
Document type Observational Study, Multicenter Study, Journal Article, Research Support, Non-U.S. Gov't
Grant support
CS/15/3/31405
British Heart Foundation - United Kingdom
PubMed
37348800
DOI
10.1016/j.hrthm.2023.06.006
PII: S1547-5271(23)02348-2
Knihovny.cz E-resources
- Keywords
- Cardiac resynchronization therapy, Complications, Conduction system pacing, His-bundle pacing, Left bundle branch area pacing,
- MeSH
- Electrocardiography methods MeSH
- Bundle of His * MeSH
- Cardiac Pacing, Artificial * methods MeSH
- Humans MeSH
- Cardiac Conduction System Disease etiology MeSH
- Prospective Studies MeSH
- Registries MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Observational Study MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: Conduction system pacing (CSP), including both left bundle branch area pacing (LBBAP) and His-bundle pacing (HBP) has been proposed as an alternative therapy option for patients with indication for cardiac pacing to treat bradycardia or heart failure. OBJECTIVE: The purpose of this study was to evaluate implant success, safety, and electrical performances of HBP and LBBAP in the multinational Physiological Pacing Registry. METHODS: The international prospective observational registry included 44 sites from 16 countries globally between November 2018 and May 2021. RESULTS: Of 870 subjects enrolled, CSP lead implantation was attempted in 849 patients. Subjects with successful CSP lead implantation were followed for 6 months (5 ± 2 months). CSP lead implantation was successful in 768 patients (90.4%). Implant success was 95.2% (239/251) for LBBAP and 88.5% (529/598) for HBP (P = .002). Procedural duration and fluoroscopy duration were comparable between LBBAP and HBP (P = .537). Capture threshold at implant was 0.69 ± 0.39 V at 0.46 ± 0.15 ms in LBBAP and 1.44 ± 1.03 V at 0.71 ± 0.33 ms in HBP (P <.001). Capture threshold at 6 months was 0.79 ± 0.33 V at 0.44 ± 0.13 ms in LBBAP and 1.59 ± 0.97 V at 0.67 ± 0.31 ms in HBP (P <.001). Pacing threshold rise ≥1 V was observed at 6 months in 3 of 208 (1.4%) of LBBAP and 55 of 418 (13.2%) of HBP (P <.001). Serious adverse events related to implant procedure or CSP lead occurred in 5 of 251 (2.0%) with LBBAP and 25 of 598 (4.2%) with HBP (P = .115). CONCLUSION: This large prospective multicenter study demonstrates that CSP is technically feasible in most patients with relatively higher implant success and suggests that, with current technology, LBBAP may have better pacing parameters than HBP.
Fakultni nemocnice Kralovske Vinohrady Czech Republic
Geisinger Heart Institute Wilkes Barre Pennsylvania
Heart Center Research LLC Huntsville Alabama
Hospital General Juan Ramón Jiménez Huelva Spain
Hospital Universitario Virgen de las Nieves Granada Spain
Inova Heart and Vascular Institute Falls Church Virginia
National Heart and Lung Institute Imperial College London London United Kingdom
Ospedale S Maria della Misericordia Rovigo Italy
References provided by Crossref.org
ClinicalTrials.gov
NCT03719040
