Long-Term Impact of Cardiac Resynchronization Therapy by Left Ventricular Septal Pacing

Area of Science:

• Cardiology
• Electrophysiology
• Heart Failure Management

Background:

• Left bundle branch area pacing (LBBAP) offers an alternative to traditional cardiac resynchronization therapy (CRT).
• Left ventricular septal pacing (LVSP) is a type of LBBAP, but its long-term efficacy for CRT indications remains unclear.

Purpose of the Study:

• To evaluate the long-term clinical outcomes and safety of LVSP as a CRT pacing strategy.
• To assess the impact of LVSP on ventricular resynchronization and heart function.

Main Methods:

• Retrospective analysis of consecutive patients meeting CRT criteria who underwent LVSP.
• Assessment of New York Heart Association functional class, NT-proBNP levels, and echocardiographic parameters at baseline and follow-up.

Main Results:

• Successful LVSP in 40 patients with a mean follow-up of 29.4 months.
• Significant reduction in QRS duration (172.5 to 135.3 ms) and improvement in left ventricular ejection fraction (26.7% to 38.8%).
• Improved New York Heart Association class and decreased NT-proBNP levels, with no procedure-related complications.

Conclusions:

• LVSP is a clinically feasible and safe pacing strategy for patients requiring CRT.
• LVSP demonstrates potential as an alternative CRT approach, though it may offer suboptimal ventricular resynchronization.