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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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Left Bundle Branch Pacing for Bradycardia in Non-obstructive Hypertrophic Cardiomyopathy Patients: Feasibility,

Wen Yang1, Tian Wu1, Yixian Wu1

  • 1Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), 300, Guangzhou Road, Nanjing, 210029, China.

Cardiovascular Drugs and Therapy
|February 27, 2023
PubMed

Insights

Left bundle branch pacing (LBBP) is a safe and feasible option for non-obstructive hypertrophic cardiomyopathy patients needing pacemakers. This innovative approach showed no decline in cardiac function or left ventricular outflow tract gradient during follow-up.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiovascular Research

Background:

  • Left bundle branch pacing (LBBP) offers a physiological alternative to conventional pacing.
  • Research on LBBP in non-obstructive hypertrophic cardiomyopathy (NOHCM) patients is limited.
  • NOHCM patients often require permanent pacemaker (PPM) implantation for bradycardia.

Purpose of the Study:

  • To evaluate the feasibility and safety of LBBP in NOHCM patients.
  • To assess the efficacy of LBBP in improving cardiac function and hemodynamics in NOHCM.
  • To compare LBBP outcomes in NOHCM patients versus a control group.

Main Methods:

  • Retrospective enrollment of 13 NOHCM patients undergoing LBBP.
  • 1:3 matching with 39 non-HCM control patients.
  • Collection of echocardiographic indices and pacing parameters.

Main Results:

  • Successful LBBP achieved in 92.3% of NOHCM patients (12/13).
  • Paced QRS duration and stimulus to left ventricular activation time were comparable between groups.
  • Higher R-wave sensing and pacing thresholds in NOHCM group, with no procedure-related complications.
  • Stable pacing parameters, preserved cardiac function, and no increase in left ventricular outflow tract gradient at 12-month follow-up.

Conclusions:

  • LBBP is a feasible and safe pacing strategy for NOHCM patients with bradycardia.
  • LBBP does not negatively impact cardiac function or left ventricular outflow tract gradient in NOHCM patients.
  • LBBP represents a promising physiological pacing option for selected NOHCM patients.
Abstract

Keywords:
BradycardiaLeft bundle branch pacingNon-obstructive hypertrophic cardiomyopathyPhysiological pacing

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