Left Bundle Branch Area Pacing With or Without Conduction System Capture in Heart Failure Models
Sijing Cheng1, Hui Li2, Yiran Hu3
1Department of Cardiology, The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
JACC. Clinical Electrophysiology
|July 6, 2024
Summary
Left bundle branch area pacing (LBBP) improves mechanical synchrony and hemodynamics compared to left ventricular septal pacing (LVSP) in a canine model of dyssynchronous heart failure.
Area of Science:
- Cardiology
- Electrophysiology
- Heart Failure Research
Background:
- Left bundle branch area pacing (LBBP) and left ventricular septal pacing (LVSP) are effective for dyssynchronous heart failure (DHF).
- The underlying mechanisms of LBBP's superior clinical outcomes remain unclear.
Purpose of the Study:
- To compare LBBP with LVSP in a DHF model.
- To investigate the mechanisms behind LBBP's better clinical performance.
Main Methods:
- A canine model with induced DHF was established.
- Pacing strategies included LBBP and LVSP, with assessments via ECG, echocardiography, hemodynamics, and protein expression analysis.
Main Results:
- LBBP demonstrated superior peak strain dispersion and hemodynamic improvement (dP/dtmax) over LVSP.
- Protein expression changes related to contraction and adhesion were observed, with LBBP partially reversing alterations in the lateral wall.
Conclusions:
- LBBP provides better mechanical synchrony and hemodynamics than LVSP in DHF.
- Reversed expression of contraction proteins may explain LBBP's efficacy, supporting its potential superiority in DHF.
