Assessment of ventricular mechanical synchronization after left bundle branch pacing using 2‐D speckle tracking echocardiography

Abstract

Background: The left bundle branch pacing (LBBP) makes the ventricular depolarization closer to the physiological state and shortens QRS duration. The purpose of this study is to explore the ventricular systolic mechanical synchronization after LBBP in comparison with traditional right ventricular pacing (RVP) using two-dimensional strain echocardiography (2D-STE). Methods: Thirty-two patients who received LBBP (n = 16) or RVP (n = 16) from October 2018 to October 2019 and met the inclusion criteria were included in this retrospective study. Electrocardiogram (ECG) characteristics, pacing parameters, pacing sites, and safety events were assessed before and after implantation. Acquisition and analysis of ventricular systolic synchronization were implemented using 2D-STE. Results: In RVP group, ECG showed left bundle branch block patterns. At LBBP, QRS morphology was in the form of right bundle branch block, and QRS durations were significantly shorter than that of the RVP QRS (109.38 ± 12.89 vs 149.38 \ ± 19.40 ms, P < .001). Both the maximum time differences (TD) and SDs of the 18-segments systolic time to peak systolic strain were significantly shorter under

Prospective evaluation of clinical safety and efficacy of left bundle branch area pacing in comparison with right ventricular sepal pacing

“…Das's study [24] and Zhang' study [14] showed that LBBaP is associated with better LV function (higher LVEF and lower LVEDD, P < .05) during short-middle term follow-up in comparison to RVAP. However, no statistical difference existed in LVEDD and LVEF between the LBBaP and RVSP groups during middleterm follow-up in our study, which were identical to other short term follow-up studies [13,20]. One possible reason for this difference is that patients enrolled into the two studies were different, patients with BBB or AV block were enrolled into Das's study [24] and patients with AV block were enrolled into Zhang's study [14], resulting in most of patients with high ventricular pacing ratio.…”

“…Subsequently, the narrow paced QRS duration (QRSd), good ventricular mechanical synchrony and a low capture threshold of LBBaP has been con rmed by several studies [11,12]. However, the results of comparison of left ventricular (LV) function such as left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) between LBBaP and right ventricular pacing (RVP) were inconsistent in several studies [13,14]. In this study, we aimed to evaluate the clinical safety, e cacy and LV function of LBBaP compared to RVSP.…”

Safety and efficacy of left bundle branch pacing in comparison with conventional right ventricular pacing

“…[ 19 ] It is worth noting that left ventricular (LV) mechanical synchrony was measured in different ways. In Cai et al study, [ 19 ] it was measured by SD-Tmsv-16; In Das et al's study, [ 21 ] it was measured by standard pulsed wave Doppler echocardiography as the interval between the onset of the QRS and the onset of the aortic and pulmonary ejection; In Sun et al study, [ 23 ] it was measured by standard deviation of 18-segment systolic times to peak 2-D strain.…”

“…The baseline of LV mechanical synchrony measured by different ways was summarized from 3 studies [ 19 , 21 , 23 ] and the heterogeneity was low ( I 2 = 45%), taking a fixed-effect model and the continuous variables were analyzed using SMD. In the LBBP group, LV mechanical synchronization parameter of the LBBP capture was similar with the native-conduction mode (WMD: −0.01; 95% CI, −0.33 to 0.31, P = .95; Fig.…”

“…Five studies [ 12 , 13 , 19 , 21 , 23 ] compared R-wave amplitude by a random-effect model. Compared with RVP patients, R-wave amplitude in LBBP patients had no different at implantation (WMD 0.04; 95% CI −1.12 to 1.19, I 2 = 59%, P = .95; Fig.…”