Left Bundle Branch Area Pacing in Pediatric Patients: Results of Initial Experience and Early Follow-Up
Tevfik Karagöz1, Musa Öztürk1, İlker Ertuğrul1
1Department of Pediatric Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Insights
Left bundle branch area pacing (LBBaP) is a safe and effective pacing method for children, showing promise for improved synchronization. This study evaluated LBBaP in pediatric patients, demonstrating positive short-term outcomes.
Area of Science:
- Cardiology
- Pediatric Electrophysiology
Background:
- Left bundle branch area pacing (LBBaP) is an emerging cardiac pacing technique.
- Limited data exists on LBBaP efficacy and safety in pediatric populations.
Purpose of the Study:
- To evaluate the safety and effectiveness of LBBaP in children.
- To assess the feasibility of LBBaP as an alternative pacing strategy in pediatric patients.
Main Methods:
- Retrospective evaluation of periprocedural and follow-up data.
- Study included 18 pediatric patients who underwent permanent pacemaker (PPM) implantation via LBBaP.
Main Results:
- Mean age was 12.3 years; indications included congenital and post-interventional atrioventricular block.
- Successful LBBaP implantation with no periprocedural or follow-up complications.
- Short-term follow-up showed favorable pacing parameters and improved ventricular activation times.
Conclusions:
- LBBaP is a safe and effective pacing alternative in pediatric patients.
- LBBaP offers improved electrical and mechanical synchronization, beneficial for children requiring high-rate ventricular pacing.
Background:
Left bundle branch area pacing (LBBaP) is a recently emerged and widely adopted technique of cardiac physiological pacing. However, there is still limited data about LBBaP in children.
Methods:
Eighteen patients who consecutively underwent permanent pacemaker (PPM) implantation via LBBaP were enrolled in this study. Periprocedural and postprocedural follow-up data were retrospectively evaluated.
Results:
The mean age was 12.3 ± 5.8 years (13 months-18 years). The mean body weight was 41.5 ± 21 kg (8-77 kg). PPM indications were congenital atrioventricular (AV) block in 13 (72%) and post-interventional AV block in 5 (27%) children. On 10/18, patients (55%) had previously received PPMs implanted in the right ventricular apex or epicardial region. The mean left ventricular activation time (LVAT), the V6-V1 inter-peak delay, and the paced QRS duration were 61 ± 9 ms, 31 ± 13 ms, and 94 ± 13 ms, respectively. No complications were observed during the procedure and follow-up. During the mean 13.5 ± 7.5 months of follow-up, the mean ventricular lead impedance was 578 ± 90 ohms, and the pacing threshold was between 0.25 and 0.75 mV.
Conclusion:
The LBBaP is an effective and safe alternative for pacing in pediatric patients at short-term follow-up. The LBBaP acts as an alternative pacing site in children, offering improved electrical and mechanical synchronization for those who need a high rate of ventricular pacing and have a longer life expectancy.
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