Comparison of Clinical Complications Between LBBAP and Traditional RVP in Long-Term Follow-Up

Area of Science:

• Cardiology
• Electrophysiology
• Medical Devices

Background:

• Traditional right ventricular pacing (RVP) can cause asynchronous cardiac contractions and increase adverse cardiac event risk.
• Left bundle branch area pacing (LBBAP) offers a more physiological alternative for ventricular pacing.

Purpose of the Study:

• To compare clinical complications between LBBAP and RVP in patients requiring ventricular pacing.
• To evaluate the safety and efficacy of LBBAP versus RVP.

Main Methods:

• Retrospective study of 248 patients with dual-chamber pacemakers and >20% ventricular pacing.
• Patients were divided into LBBAP (n=98) or RVP (n=150) groups.
• Primary outcome: ventricular lead complications; Overall complications included lead issues, adverse cardiovascular events, and death.

Main Results:

• LBBAP group had significantly shorter pacing QRS duration (110.3±22.7 ms) vs. RVP (140.0±29.3 ms).
• Ventricular lead complications were higher in LBBAP (62.0%) vs. RVP (36.5%) (p=0.03).
• Overall complications were comparable between LBBAP and RVP at one-year follow-up. LBBAP showed reduced LA and LVEDD at follow-up.

Conclusions:

• LBBAP patients experienced more ventricular lead threshold increases and amplitude decreases than RVP patients.
• Overall complication risk was similar between LBBAP and RVP within one year.
• LBBAP is safe and effective for patients with >20% ventricular pacing and preserved LVEF.