Effects of adaptive left bundle branch-optimized cardiac resynchronization therapy: a single centre experience
Xiang-Fei Feng1, Ling-Chao Yang2, Yan Zhao2
1Department of Cardiology, School of Medicine, Xinhua Hospital, Shanghai Jiao Tong University, #1665, KongJiang Road, Shanghai, 200092, China. fengxiangfei@xinhuamed.com.cn.
BMC Cardiovascular Disorders
|August 6, 2022
Summary
Left bundle branch area pacing combined with coronary venous pacing (LOT-aCRT) is a feasible approach for adaptive cardiac resynchronization therapy. This novel method significantly narrows QRS duration and improves heart function in patients with systolic heart failure and LBBB.
Area of Science:
- Cardiology
- Electrophysiology
- Heart Failure Management
Background:
- Adaptive cardiac resynchronization therapy (aCRT) improves patient outcomes.
- Left bundle branch area pacing (LBBAP) shows promise as an alternative aCRT option.
- Left bundle branch area pacing combined with coronary venous pacing (LOT-aCRT) is a novel technique for aCRT.
Purpose of the Study:
- To assess the feasibility and clinical outcomes of LOT-aCRT.
- To compare LOT-aCRT with conventional biventricular pacing (BVP-aCRT).
Main Methods:
- LOT-aCRT was attempted in patients indicated for CRT.
- Patients were divided into LOT-aCRT (LBBAP + LV pacing) and BVP-aCRT groups.
- Feasibility and outcomes were evaluated, including QRS duration, LVEF, and NT-proBNP levels.
Main Results:
- LOT-aCRT significantly narrowed QRS duration compared to baseline and BVP-aCRT.
- Both LOT-aCRT and BVP-aCRT improved LVEF and NT-proBNP levels.
- LOT-aCRT demonstrated more significant improvements in LVEF and NT-proBNP than BVP-aCRT.
Conclusions:
- LOT-aCRT is clinically feasible for patients with systolic heart failure and LBBB.
- LOT-aCRT effectively narrows QRS duration and enhances left ventricular function.
- LOT-aCRT offers superior improvements in cardiac function parameters compared to BVP-aCRT.
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