Comparison of electrical characteristics and pacing parameters of pacing different parts of the His-Purkinje system in bradycardia patients

Liu, Xi; Gu, Min; Hua, Wei; Hu, Yiran; Niu, Hongxia; Cai, Mengxin; Zhang, Nixiao; Zhang, Shu

doi:10.1007/s10840-021-00962-8

Cited by 12 publications

(3 citation statements)

References 15 publications

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“…In addition to the clinical benefits and electrical synchrony, pacing parameters were also important in pacing treatments, such as pacing threshold and impedance. The early studies found that the pacing threshold of LBBAP was significantly lower than that of HBP, 35,54 which was even up to 2.75 V/1.0 ms in some cases. 33 Our results were consistent with those of the previous studies that reported that HBP had a higher pacing threshold.…”

Section: Exploration Of Inconsistency and Publication Biasmentioning

confidence: 99%

Comparative effects of left bundle branch area pacing, His bundle pacing, biventricular pacing in patients requiring cardiac resynchronization therapy: A network meta‐analysis

Hua

Wang

Kong

et al. 2022

Clinical Cardiology

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Background:The comparative effects of different types of cardiac resynchronization therapy (CRT) delivered by biventricular pacing (BVP), His bundle pacing (HBP), and left bundle branch area pacing (LBBAP) remain inconclusive.Hypothesis: HBP and LBBAP may be advantageous over BVP for CRT.Methods: PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched for studies that reported the effects after BVP, HBP, and LBBAP for CRT. The effects between groups were compared by a frequentist random-effects network meta-analysis (NMA), by which the mean differences (MDs) and 95% confidence intervals (CIs) were calculated.Results: Six articles involving 389 patients remained for the final meta-analysis. The mean follow-up of these studies was 8.03 ± 3.15 months. LBBAP resulted in a greater improvement in LVEF% (MD = 7.17, 95% CI = 4.31 to 10.04), followed by HBP (MD = 4.06, 95% CI = 1.09 to 7.03) compared with BVP. HBP resulted in a narrower QRS duration (MD = 31.58 ms, 95% CI = 12.75 to 50.40), followed by LBBAP (MD = 27.40 ms, 95% CI = 10.81 to 43.99) compared with BVP. No significant differences of changes in LVEF improvement and QRS narrowing were observed between LBBAP and HBP. The pacing threshold of LBBAP was significantly lower than those of BVP and HBP. Conclusion:The NMA first found that LBBAP and HBP resulted in a greater LVEF improvement and a narrower QRS duration compared with BVP. Additionally, LBBAP resulted in similar clinical outcomes but with lower pacing thresholds, and may therefore offer advantages than does HBP for CRT.

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Section: Exploration Of Inconsistency and Publication Biasmentioning

confidence: 99%

Comparative effects of left bundle branch area pacing, His bundle pacing, biventricular pacing in patients requiring cardiac resynchronization therapy: A network meta‐analysis

Hua

Wang

Kong

et al. 2022

Clinical Cardiology

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“…The incidence of progressive rise in thresholds and lead revision rates amongst early adopters of HBP has been variable in the literature. [22][23] Bhatt et al, Keene et al and Teigeler et al in their respective single center reports described 8%, 7.5% and 11% rates of lead revision/intervention, respectively. 11,14,24 On the other hand, Chaumont et al reported a much lower incidence of lead revisions in their multicenter experience (3.4%) and Qian et al reported no lead revisions.…”

Section: Discussionmentioning

confidence: 97%

A Single Center Experience with Early Adoption of Physiologic Pacing Approaches

Oates

Kawamura

Turagam

et al. 2021

Preprint

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Background: Increasing interest in physiological pacing has been countered with challenges such as accurate lead deployment and increasing pacing thresholds with His-bundle pacing (HBP). More recently, left bundle branch area pacing (LBBAP) has emerged as an alternative approach to physiologic pacing. Objective: To compare procedural outcomes and pacing parameters at follow-up during initial adoption of HBP and LBBAP at a single center. Methods: Retrospective review, from September 2016 to January 2020, identified the first 50 patients each who underwent successful HBP or LBBAP. Pacing parameters were then assessed at first follow-up after implantation and after approximately one year, evaluating for acceptable pacing parameters defined as sensing R-wave amplitude >5 mV, threshold <2.5 V @ 0.5 ms and impedance between 400 and 1200 Ohms. Results: The HBP group was younger with lower ejection fraction compared to LBBP (73.2±15.3 vs 78.2±9.2 years, p=0.047; 51.0±15.9% vs 57.0±13.1%, p = 0.044). Post-procedural QRS widths were similarly narrow (119.8±21.2 vs. 116.7±15.2ms; p = 0.443) in both groups. Significantly fewer patients with HBP met the outcome for acceptable pacing parameters at initial follow-up (56.0% vs 96.4%, p = 0.001) and most recent follow-up (60.7% vs 94.9%, p = <0.001; at 399±259 vs. 228±124 days, p = <0.001). More HBP patients required lead revision due to early battery depletion (0 vs 13.3%, at an average of 664 days). Conclusion: During initial adoption, as compared with LBBAP, HBP is associated with a significantly higher frequency of unacceptable pacing parameters, energy consumption, and lead revisions.

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“…The incidence of progressive rise in thresholds and lead revision rates amongst early adopters of HBP has been variable in the literature 24,25 . Bhatt et al, Keene et al, and Teigeler et al described 8%, 7.5%, and 11% rates of lead revision/intervention, respectively 11,14,26 .…”

Section: Discussionmentioning

confidence: 99%

A single‐center experience with early adoption of physiologic pacing approaches

Oates

Kawamura

Turagam

et al. 2021

Cardiovasc electrophysiol

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Background Increasing interest in physiological pacing has been countered with challenges such as accurate lead deployment and increasing pacing thresholds with His‐bundle pacing (HBP). More recently, left bundle branch area pacing (LBBAP) has emerged as an alternative approach to physiologic pacing. Objective To compare procedural outcomes and pacing parameters at follow‐up during initial adoption of HBP and LBBAP at a single center. Methods Retrospective review, from September 2016 to January 2020, identified the first 50 patients each who underwent successful HBP or LBBAP. Pacing parameters were then assessed at first follow‐up after implantation and after approximately 1 year, evaluating for acceptable pacing parameters defined as sensing R‐wave amplitude >5 mV, threshold <2.5 V @ 0.5 ms, and impedance between 400 and 1200 Ω. Results The HBP group was younger with lower ejection fraction compared to LBBAP (73.2 ± 15.3 vs. 78.2 ± 9.2 years, p = .047; 51.0 ± 15.9% vs. 57.0 ± 13.1%, p = .044). Post‐procedural QRS widths were similarly narrow (119.8 ± 21.2 vs. 116.7 ± 15.2 ms; p = .443) in both groups. Significantly fewer patients with HBP met the outcome for acceptable pacing parameters at initial follow‐up (56.0% vs. 96.4%, p = .001) and most recent follow‐up (60.7% vs. 94.9%, p ≤ .001; at 399 ± 259 vs. 228 ± 124 days, p ≤ .001). More HBP patients required lead revision due to early battery depletion or concern for pacing failure (0% vs. 13.3%, at a mean of 664 days). Conclusion During initial adoption, HBP is associated with a significantly higher frequency of unacceptable pacing parameters, energy consumption, and lead revisions compared with LBBAP.

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Comparison of electrical characteristics and pacing parameters of pacing different parts of the His-Purkinje system in bradycardia patients

Cited by 12 publications

References 15 publications

Comparative effects of left bundle branch area pacing, His bundle pacing, biventricular pacing in patients requiring cardiac resynchronization therapy: A network meta‐analysis

Comparative effects of left bundle branch area pacing, His bundle pacing, biventricular pacing in patients requiring cardiac resynchronization therapy: A network meta‐analysis

A Single Center Experience with Early Adoption of Physiologic Pacing Approaches

A single‐center experience with early adoption of physiologic pacing approaches

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