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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

10.6K

Feasibility and safety of left bundle branch area pacing-cardiac resynchronization therapy in elderly patients

Domenico Grieco1, Edoardo Bressi2,3,4, Kamil Sedláček5

  • 1Department of Cardiovascular Sciences, Policlinico Casilino of Rome, Via Casilina, 1049, 00169, Rome, Italy.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|March 10, 2022
PubMed

Insights

Left bundle branch area pacing (LBBAP) is a safe and effective method for cardiac resynchronization therapy (CRT) in elderly patients. This study shows LBBAP successfully reduced QRS duration and improved ejection fraction with low complication rates.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Left bundle branch area pacing (LBBAP) is an emerging technique for cardiac resynchronization therapy (CRT).
  • Its feasibility and safety in elderly patients with heart failure with reduced ejection fraction and left bundle branch block remain under-investigated.

Purpose of the Study:

  • To evaluate the feasibility and safety of LBBAP-CRT in elderly patients (≥75 years) compared to younger patients (<75 years).
  • To compare pacing parameters and complication rates between the two age groups over a 6-month follow-up.

Main Methods:

  • Consecutive patients indicated for CRT were enrolled.
  • Pacing parameters and complication rates were compared between elderly and younger LBBAP-CRT recipients.
  • A 6-month follow-up period was utilized.

Main Results:

  • LBBAP was successful in 92% of patients (45% elderly).
  • Both groups showed significant QRS duration reduction and LVEF improvement (p<0.0001).
  • Pacing thresholds, R wave amplitudes, fluoroscopic and procedural times were comparable. Complication rates were low and similar between groups.

Conclusions:

  • LBBAP is a feasible and safe pacing technique for elderly CRT candidates.
  • It provides physiological pacing with effective QRS and LVEF improvements.
  • Low complication rates support LBBAP as a viable CRT option for the elderly.
Abstract

Keywords:
Cardiac resynchronization therapyConduction system pacingElderly patientsHeart failureLeft bundle branch area pacing

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