Conduction disease in cardiac amyloidosis patients: A case series suggesting a role for left bundle branch area
Ojas H Mehta1, Keyrian Louis Le Gratiet2, Markus Sikkel1
1Royal Jubilee Hospital, Vancouver Island Health Authority, British Columbia, Canada.
Insights
Transthyretin cardiac amyloidosis (ATTR-CA) is a heart failure cause in elderly patients. Left bundle branch area pacing (LBBAP) offers a viable pacing option for these patients requiring pacemakers.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Amyloidosis Research
Background:
- Transthyretin cardiac amyloidosis (ATTR-CA) is a growing cause of heart failure, particularly in elderly individuals with preserved ejection fraction.
- Patients with ATTR-CA needing pacemakers often have preserved ejection fraction and may not qualify for cardiac resynchronization therapy (CRT).
Abstract:
Transthyretin Cardiac amyloidosis (ATTR-CA) is an increasingly recognised cause of heart failure in our elderly patients with preserved ejection fraction. Patients with ATTR-CA who require permanent pacemaker implantation often have preserved ejection fraction and do not meet the clinical indication for cardiac resynchronization therapy (CRT). In these patients, left bundle branch area pacing (LBBAP) can be a reasonable option to maximise physiological activation of the left ventricle. We describe a series of three patients with cardiac amyloidosis who have undergone LBBAP with the use of lumenless leads and successful capture of the myocardium and left bundle branch region.
