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Effects of coronary artery disease in patients with permanent left bundle branch area pacing: A retrospective study

Yu Shan1,2, Maoning Lin1,2, Miao Ye3

  • 1Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, No 3 East of Qinchun Road, Hangzhou, Zhejiang, 310000, China.

Heliyon
|January 25, 2024
PubMed

Insights

Coronary artery disease (CAD) significantly increases the capture threshold during left bundle branch area pacing (LBBaP). Patients without CAD may experience safer LBBaP parameters, suggesting CAD is a risk factor for increased capture thresholds.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Myocardial ischemia affects traditional pacing parameters.
  • The impact of coronary artery disease (CAD) on left bundle branch area pacing (LBBaP) is not well understood.
  • LBBaP is a physiological pacing method.

Purpose of the Study:

  • To investigate whether CAD impacts pacing parameters and electrophysiological characteristics of LBBaP.
  • To determine if CAD is associated with changes in LBBaP settings.

Main Methods:

  • 176 patients undergoing LBBaP were divided into CAD and Non-CAD groups based on coronary angiography.
  • Pacing parameters and electrophysiological characteristics were recorded during LBBaP implantation.
  • Multivariate logistic regression analyzed the association between CAD and higher capture threshold.

Main Results:

  • CAD patients (n=61) had a higher capture threshold (0.82 ± 0.28 V) compared to Non-CAD patients (n=115, 0.67 ± 0.22 V).
  • CAD was independently associated with a higher capture threshold (aOR 3.418).
  • CAD patients exhibited lower R-wave amplitude (10.1 ± 2.7 mV vs. 12.5 ± 4.8 mV).

Conclusions:

  • Patients without CAD may have safer pacing parameters during LBBaP.
  • CAD appears to be a risk factor for increased capture thresholds in permanent LBBaP.
Abstract

Keywords:
Capture threshold increaseCoronary artery disease (CAD)Electrophysiological characteristicsLeft bundle branch area pacing (LBBaP)Pacing parametersRisk factor

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