Left bundle branch area pacing (LBBAP) was reported to improve cardiac function by correcting complete left bundle branch block (CLBBB). Our study aimed to compare the efficacy of LBBAP and biventricular pacing (BIVP) in heart failure patients with CLBBB.
Ten patients prospectively underwent LBBAP (LBB-CRT group) and 30 patients received BIVP (BIV-CRT group) were matched using propensity score matching. LBBAP was achieved by trans-interventricular septum method. Echocardiography, electrocardiogram, NYHA classification and blood B-type natriuretic peptide concentration were evaluated at pre-implantation and at 6-month follow up. CRT response was defined as at least 15% decrease in left ventricular end systolic volume.
In the LBB-CRT group, CLBBB were successfully corrected by LBBAP with no complications. QRS duration (QRSd) significantly decreased after implantation in both groups, and the decrease of QRSd in the LBB-CRT group was significantly greater than that in the BIV-CRT group (60.80±20.09ms vs 33.00±21.48ms, P=0.0009). The echocardiographic measurements including left ventricular end-diastolic diameter, left ventricular end-systolic diameter and left ventricular ejection fraction significantly improved after 6 months in both groups. The response rate was significantly higher in LBB-CRT group than BIV-CRT group (100.00% vs 63.33%, p=0.038). The percentage of patients in NYHA classification grade I and II was significantly higher in the LBB-CRT group compared to that in the BIV-CRT group (median 1.5 vs. 2.0, p=0.029) at 6-month follow-up.
It is effective and safe to correct CLBBB with LBBAP in heart failure patients. Compared with BIVP, LBBAP can better optimize electrical synchrony and improve cardiac function. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.