His bundle pacing and left bundle branch area pacing: Feasibility and safety
Carolina Saleiro1, Pedro A Sousa1, Catarina Nogueira2
1Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Summary
His bundle pacing (HBP) and left bundle branch area pacing (LBBAP) are feasible and safe physiological pacing methods for patients requiring pacemakers. Both techniques demonstrated high success rates and stable pacing parameters at three months.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Device Technology
Background:
- Growing interest in physiological pacing methods like His bundle pacing (HBP) and left bundle branch area pacing (LBBAP).
- These techniques aim to provide more natural cardiac stimulation compared to traditional pacing.
- Assessing the feasibility and safety of HBP and LBBAP is crucial for clinical adoption.
Purpose of the Study:
- To evaluate the feasibility and safety of His bundle pacing (HBP) and left bundle branch area pacing (LBBAP).
- To compare procedural endpoints and pacing parameters between HBP and LBBAP.
- To assess the long-term stability of pacing parameters at three-month follow-up.
Main Methods:
- Prospective, observational, single-center study involving 46 patients requiring a pacemaker.
- Attempted His bundle pacing (HBP) or left bundle branch area pacing (LBBAP) between July 2020 and November 2021.
- Assessed procedural success, pacing thresholds, R-wave amplitude, paced QRS duration, procedural time, and fluoroscopy time at implantation and three-month follow-up.
Main Results:
- High overall acute procedural success rate of 96%; 91% for HBP and 100% for LBBAP.
- LBBAP demonstrated significantly reduced fluoroscopy time compared to HBP (p=0.05).
- Both HBP and LBBAP showed stable pacing thresholds at three months, with 3 re-interventions in the HBP group (6.5%).
Conclusions:
- His bundle pacing (HBP) and left bundle branch area pacing (LBBAP) are feasible and safe pacing options.
- These physiological pacing techniques can be successfully implemented in patients indicated for pacemakers.
- Further research may explore long-term outcomes and broader clinical application of HBP and LBBAP.
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