Effect of left bundle branch pacing on right ventricular function: A 3-dimensional echocardiography study.
Fangyan Tian1, Haobo Weng2, Ao Liu2
1Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai Institute of Medical Imaging, Shanghai, China; Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai, China; Department of Ultrasound Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.
Left bundle branch pacing (LBBP) significantly improves right ventricular (RV) function and electrical/mechanical resynchronization. Existing RV dysfunction does not hinder the positive effects of LBBP on left ventricular remodeling.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Imaging
Background:
- The impact of left bundle branch pacing (LBBP) on right ventricular (RV) function remains unclear, with conflicting data on cardiac resynchronization therapy's effects.
- Investigating LBBP's influence on RV function is crucial for understanding its comprehensive benefits.
Purpose of the Study:
- To determine the effect of LBBP on RV function.
- To assess the response of patients with RV dysfunction (RVD) to LBBP.
Main Methods:
- Prospective study of 65 LBBP candidates undergoing echocardiography at baseline and 6-month follow-up.
- Patients categorized into RVD and no RVD groups based on baseline RV ejection fraction (RVEF).
- LBBP response defined as left ventricular (LV) reverse remodeling (≥15% reduction in LV end-systolic volume).
Main Results:
- LBBP significantly reduced QRS duration, LV size, and improved LVEF and mechanical dyssynchrony in both groups.
- Significant improvements in RV volumes and RVEF were observed in the RVD group post-LBBP.
- LV reverse remodeling occurred similarly in both RVD and no RVD groups, indicating comparable benefits.
Conclusions:
- LBBP effectively achieves electrical and mechanical resynchronization, enhancing RV volumes and function.
- Pre-existing RV dysfunction does not impede the positive remodeling effects of LBBP on the LV.
