Mid-term feasibility, safety and outcomes of left bundle branch pacing–single center experience

Ponnusamy, Shunmuga Sundaram; Muthu, Giridhar; Kumar, Mahesh; Bopanna, Dasarath; Anand, Vijesh; Kumar, Sumit

doi:10.1007/s10840-020-00807-w

Cited by 26 publications

(32 citation statements)

References 34 publications

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“…The lead parameters remained stable during follow up ( Table 1 B). All these findings are comparable to the published studies by other authors on LBBP 5 , 7 , 8 …”

Section: Discussionsupporting

confidence: 93%

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Feasibility, safety and outcomes of left bundle branch pacing in octogenarians

Ponnusamy

Bopanna

Syed

et al. 2021

Indian Heart Journal

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Objectives Left bundle branch pacing (LBBP) provides physiological pacing at low and stable threshold. The safety and efficacy of LBBP in elderly population is unknown. Our study was designed to assess the safety, efficacy and electrophysiological parameters of LBBP in octogenarian (≥80 years) population. Results LBBP was successful in 10 out of 11 patients. Mean age 82.1 ± 2.5 yrs. Follow up duration 7.7 months(range4–10). Indication for pacing included atrioventricular (AV) block 5 patients, Left bundle branch block (LBBB) with low ejection fraction (EF) 4 patients, sinus node dysfunction in 1. QRS duration reduced from 145.9 ± 27.7ms to 107.1 ± 9.5ms ( p value0.00001) LV ejection fraction increased from 47.6% to 58.4% after LBBP ( p value0.017). Pacing threshold was 0.58 ± 0.22 V and sensed R wave 17.35 ± 6.5 mV and it remained stable during follow up. LBBB with low EF patients also showed similar reduction in QRS duration along with improvement in LVEF. Conclusion LBBP is a safe and effective strategy (91% acute success) of physiological pacing in elderly patients. LBBP also provided effective resynchronization therapy in our small group of elderly patients. The pacing parameters remained stable over a period of 10 months follow up.

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“…The lead parameters remained stable during follow up ( Table 1 B). All these findings are comparable to the published studies by other authors on LBBP 5 , 7 , 8 …”

Section: Discussionsupporting

confidence: 93%

“…The findings are comparable to the general data on LBBP in Indian patients by our group where we showed 94% acute success rate with threshold of 0.59 ± 0.22 V and R wave of 14 ± 7 mV which remained stable over 12 months follow-up. 7 QRS duration was reduced from 144 ± 34ms to 110 ± 12ms along with improvement in LVEF from 44% to 53%.…”

Section: Resultsmentioning

confidence: 93%

Feasibility, safety and outcomes of left bundle branch pacing in octogenarians

Ponnusamy

Bopanna

Syed

et al. 2021

Indian Heart Journal

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“…1 Though studies have shown the feasibility of LBBP as an alternative strategy for cardiac resynchronization therapy the long-term safety of LBBP is yet to be available. [2][3][4] A prospective study by Su et al, 5 showed stable pacing parameters at mean followup of 2 years. Currently available tools for lead extraction may not be able to safely remove the deeply positioned LBBP lead in the proximal interventricular septum.…”

Section: Introductionmentioning

confidence: 99%

Late dislodgement of left bundle branch pacing lead and successful extraction

Ponnusamy

Vijayaraman

2021

Cardiovasc electrophysiol

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A 61-years-old male underwent left bundle branch pacing for nonischemic dilated cardiomyopathy with recurrent heart failure. Left bundle branch pacing (LBBP) resulted in reduction in QRS duration along with improvement in left ventricular ejection fraction (LVEF) to 64% during follow-up. Two years after implantation he had recurrence of symptoms along with decline in LVEF to 51%. Late lead dislodgement was diagnosed and re-do LBBP was planned. The lead was extracted enmasse without complication and a new 3830 lead was positioned deep inside the proximal septum to capture the left bundle. Postprocedure echocardiography showed no ventricular septal defect or damage to tricuspid leaflet.

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“…Based on the above research results and the anatomical characteristics of His‐Purkinje system, we propose that in patients with mechanical impairment after TAVR, conduction disorders may be beyond His bundle or even distal, while LBBP could offer an alternative option in post‐TAVR patients with unsuccessful HBP. LBBP is delivered by bypassing the pathologic region, although proximal LBB was probably impaired by TAVR while the distal network beyond the site of block was probably intact, still LBBP generates a narrow paced QRS duration and a low, stable pacing capture threshold 5,11 . For this case, it may be the cause of nonselective LBBP.…”

Section: Discussionmentioning

confidence: 92%

Rapid reversal of heart failure by correcting left bundle branch block induced by transcatheter aortic valve replacement

Zhang

Wang

et al. 2020

Pacing Clinical Electrophis

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Transcatheter aortic valve replacement (TAVR) induced pathological damage in cardiac conduction system leads to symptomatic bradycardia and electric dyssynchrony such as left bundle branch block (LBBB) is associated with an increased risk for heart failure. Left bundle branch pacing (LBBP) has emerged as an alternative method for delivering physiological pacing to achieve electrical synchrony of the left ventricle. We report a case of heart failure patient with new onset LBBB (NO‐LBBB) induced by TAVR, LBBP corrected the NO‐LBBB and reversed the heart function with stable capture and correction threshold.

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Mid-term feasibility, safety and outcomes of left bundle branch pacing–single center experience

Cited by 26 publications

References 34 publications

Feasibility, safety and outcomes of left bundle branch pacing in octogenarians

Feasibility, safety and outcomes of left bundle branch pacing in octogenarians

Late dislodgement of left bundle branch pacing lead and successful extraction

Rapid reversal of heart failure by correcting left bundle branch block induced by transcatheter aortic valve replacement

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