Echocardiographic Evaluation of the Effect on Left Ventricular Function Between Left Bundle Branch Pacing and Right
Yu Mao1, Yuan Xie1, Jiani Tang1
1Department of Cardiology, Tongji Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Insights
Permanent left bundle branch pacing (LBBP) improved cardiac function and reduced tricuspid regurgitation (TR) compared to right ventricular pacing (RVP) over one year. LBBP offers a safe and effective alternative for cardiac pacing.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Pacing
Background:
- Traditional right ventricular pacing (RVP) can lead to dyssynchrony and impaired left ventricular function.
- Left bundle branch pacing (LBBP) is an alternative pacing strategy aiming to improve ventricular synchrony.
Purpose of the Study:
- To compare the effects of permanent left bundle branch pacing (LBBP) versus traditional right ventricular pacing (RVP) on left ventricular function.
- To evaluate cardiac hemodynamic changes and safety profiles of LBBP and RVP.
Main Methods:
- A prospective study included 78 patients undergoing pacemaker implantation, divided into LBBP and RVP groups.
- Patients were followed for one year, with assessments of electrocardiogram (ECG) characteristics, pacing parameters, left ventricular ejection fraction (LVEF), and tricuspid regurgitation (TR).
Main Results:
- LBBP group showed a greater decrease in left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD).
- Significant improvement in tricuspid regurgitation (TR) was observed in the LBBP group compared to the RVP group (P=0.016).
- Pacing parameters were stable throughout the follow-up period for both groups.
Conclusions:
- Permanent LBBP demonstrates favorable cardiac hemodynamic effects with good stability and safety.
- LBBP may be a beneficial option for patients with severe tricuspid regurgitation, potentially reducing its severity at one-year follow-up.
Purpose:
The purpose of this study was to assess the left ventricular function effects of permanent left bundle branch pacing (LBBP) versus traditional right ventricular pacing (RVP).
Patients And Methods:
Consecutive patients receiving pacemaker implantation were included and divided into left bundle branch block (LBBB) group and right ventricular pacing (RVP) group. Baseline characteristics were collected, and they received 1-year follow-up. Electrocardiogram (ECG) characteristics and pacing parameters were assessed before and after implantation. Cardiac function parameters such as left ventricular ejection fraction (LVEF) and tricuspid regurgitation (TR) were recorded and compared.
Results:
Of 78 patients included, 45 patients received LBBP (mean age, 72.7 ± 12.2 years; male, 55.6%) and 33 patients underwent RVP (mean age 72.9 ± 11.8 years; male, 63.6%). The pacing parameters were satisfactory during the implantation and remained stable during mid-term follow-up. During the follow-up period, LBBP patients had a greater decrease in LVEDD and LVESD. The TR in the LBBP group was significantly improved as compared to the RVP group (P=0.016).
Conclusion:
Permanent LBBP achieves favorable cardiac hemodynamic effects with good stability and safety. LBBP may reduce severe TR at 1-year follow-up, and LBBP may be an option for patients with severe TR.
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