小児患者における左脚ブロック領域ペーシング：初期経験と早期フォローアップの結果

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.

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.

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.

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.