Durability of left bundle branch area pacing.
Nikhil A Mehta1, Bilal Saqi, Syed R A Sabzwari
1Department of Electrophysiology, Lehigh Valley Heart Institute, Allentown, Pennsylvania, USA.
Journal of Cardiovascular Electrophysiology
|May 19, 2022
Summary
Left bundle branch area pacing (LBBAP) is a safe and effective conduction system pacing method. One-year follow-up shows durable performance, with patients experiencing narrower QRS durations, especially those with left bundle branch block.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Left bundle branch area pacing (LBBAP) is an emerging technique in conduction system pacing.
- Limited long-term data exists regarding the safety and performance of LBBAP one year post-implantation.
Purpose of the Study:
- To evaluate the long-term safety and performance of LBBAP over 12 months.
- To assess the impact of LBBAP on QRS duration in different patient subgroups.
Main Methods:
- Retrospective evaluation of 65 patients who received LBBAP for bradycardia using the SelectSecure 3830 lead.
- Analysis of clinical variables, lead parameters (thresholds, impedance), and QRS duration at implant and follow-up intervals (3, 6, 12 months).
Main Results:
- Mean patient age was 75.7 years; common indications included atrioventricular block (55%) and sinus node dysfunction (19%).
- Pacing thresholds increased by 48% over 12 months, but remained stable.
- Significant QRS narrowing (24 ms) was observed in patients with pre-existing left bundle branch block (BBB); pacing impedance was unchanged.
- No procedure-related complications were reported.
Conclusions:
- LBBAP demonstrates durable performance over 12 months with relatively stable pacing thresholds.
- LBBAP is a safe conduction system pacing option, particularly beneficial for patients with left bundle branch block, leading to the narrowest paced QRS durations.
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