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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Comparison of ventricular synchrony in children with left bundle branch area pacing and right ventricular septal

Jinghao Li1,2, He Jiang1,2, Jian Cui1

  • 1Department of Pediatric Cardiology, Heart Center, The First Hospital of Tsinghua University (Beijing Huaxin Hospital), Beijing, China.

Cardiology in the Young
|January 5, 2023
PubMed

Insights

Left bundle branch area pacing in children leads to better ventricular synchrony and narrower QRS duration compared to right ventricular septal pacing. This study highlights LBBAP as a superior pacing strategy for pediatric patients.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Cardiac Pacing

Background:

  • Complete atrioventricular block in children necessitates permanent pacemaker implantation.
  • Optimizing ventricular synchrony is crucial for long-term cardiac function in pediatric patients.
  • Traditional right ventricular septal pacing may lead to suboptimal ventricular synchrony.

Purpose of the Study:

  • To compare the postoperative ventricular synchrony between left bundle branch area pacing (LBBAP) and right ventricular septal pacing (RVSP) in children.
  • To determine the optimal ventricular pacing site for improving cardiac function in pediatric patients with complete atrioventricular block.

Main Methods:

  • Retrospective study of children with complete atrioventricular block undergoing permanent pacemaker implantation (March 2019 - August 2021).
  • Patients were divided into LBBAP and RVSP groups.
  • Two-dimensional speckle tracking echocardiography was utilized to assess ventricular synchrony.

Main Results:

  • LBBAP group showed significantly narrower paced QRS duration (100.2 ± 9.3 ms) than RVSP group (115.4 ± 15.1 ms).
  • LBBAP group demonstrated improved left ventricular intraventricular synchrony and shorter interventricular mechanical delay.
  • Lower ventricular electrode capture thresholds were observed in the LBBAP group.

Conclusions:

  • Left bundle branch area pacing in children results in superior postoperative ventricular synchrony compared to right ventricular septal pacing.
  • LBBAP is associated with narrower QRS duration and better pacing parameters in pediatric patients.
  • LBBAP emerges as a promising pacing strategy for enhancing cardiac function in children.
Abstract

Keywords:
Childleft bundle branch area pacingpacemakerspeckle tracking echocardiographyventricular synchrony

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