Clinical Research

Effect of left bundle branch area pacing on new⁃onset atrial arrhythmia after implantation

  • Yongxu ZHANG ,
  • Yuesong WANG ,
  • Da YANG ,
  • Xuebin DONG ,
  • Mingyong CAO ,
  • Shaojun WANG ,
  • Kexiang. TU
Expand
  • Wannan Medical College,Wuhu 241002,China

Received date: 2023-11-17

  Online published: 2024-07-09

Abstract

Objective To investigate the effect of left bundle branch area pacing (LBBaP) on new-onset atrial fibrillation (NOAF) and atrial high rate episodes (AHREs) in patients with atrioventricular block (AVB). Methods Eighty-four patients with Ⅲ°AVB for pacemaker implantaion were divided into the LBBaP group (n = 42) and the RVSP group (n = 42) based on the site of the ventricular leads. The two groupswere compared in terms of the pre- and post- operative QRSd, ventricular pacing parameters, complications, incidence of stroke, NOAF and AHREs. Results (1) The incidence of postoperative NOAF and AHREs in the LBBaP group was significantly lower compared with RVSP group (P < 0.05). (2) The p-QRSd in the LBBaP group was significantly shorter compared with RVSP group (P < 0.05). (3) The two groups showed no significant differences in ventricular pacing parameters, incidence of complications and stroke events (P > 0.05). Conclusion LBBaP is superior to right ventricular pacing in reducing the incidence of postoperative AHREs and NOAF in patients after implantation and improving the prognosis of patients.

Cite this article

Yongxu ZHANG , Yuesong WANG , Da YANG , Xuebin DONG , Mingyong CAO , Shaojun WANG , Kexiang. TU . Effect of left bundle branch area pacing on new⁃onset atrial arrhythmia after implantation[J]. The Journal of Practical Medicine, 2024 , 40(13) : 1846 -1850 . DOI: 10.3969/j.issn.1006-5725.2024.13.014

References

1 KUSUMOTO F M, SCHOENFELD M H, BARRETT C, et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society[J]. Heart Rhythm, 2019, 16(9):e128-e226. doi:10.1161/cir.0000000000000627
2 CHáVEZ-GONZáLEZ E, NODARSE-CONCEPCIóN A, DONOIU I, et al. Increased QRS duration and dispersion are associated with mechanical dyssynchrony in patients with permanent right ventricular apical pacing[J]. Discoveries (Craiova), 2021, 9(2):e128. doi:10.15190/d.2021.7
3 PASTORE G, ZANON F, BARACCA E, et al. The risk of atrial fibrillation during right ventricular pacing[J]. Europace, 2016, 18(3):353-358. doi:10.1093/europace/euv268
4 CAI B, HUANG X, LI L, et al. Evaluation of cardiac synchrony in left bundle branch pacing: Insights from echocardiographic research[J]. J Cardiovasc Electrophysiol, 2020, 31(2):560-569. doi:10.1111/jce.14342
5 PENG X, CHEN Y, WANG X, et al. Safety and efficacy of His-bundle pacing/left bundle branch area pacing versus right ventricular pacing: a systematic review and meta-analysis[J]. J Interv Card Electrophysiol, 2021, 62(3):445-459. doi:10.1007/s10840-021-00998-w
6 高阳,李苗苗,于海波,等. 不同房室传导阻滞部位患者的希氏-浦肯野系统起搏成功率[J]. 中华心血管病杂志, 2022,50(6):543-548. doi:10.3760/cma.j.cn112148-20220403-00238
7 朱路勇,王岳松,董学滨,等. 左束支区域起搏用于心室起搏电极植入治疗心动过缓的临床疗效及安全性[J]. 山东医药,2022,62(7):26-30. doi:10.3969/j.issn.1002-266X.2022.07.007
8 HINDRICKS G, POTPARA T, DAGRES N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC[J]. Eur Heart J, 2021, 42(5):373-498. doi:10.1093/eurheartj/ehaa945
9 ZHANG J, WANG Z, ZU L, et al. Simplifying Physiological Left Bundle Branch Area Pacing Using a New Nine-Partition Method[J]. Can J Cardiol, 2021, 37(2):329-338. doi:10.1016/j.cjca.2020.05.011
10 POTPARA T S, POLOVINA M M, MARINKOVIC J M, et al. A comparison of clinical characteristics and long-term prognosis in asymptomatic and symptomatic patients with first-diagnosed atrial fibrillation: the Belgrade Atrial Fibrillation Study[J]. Int J Cardiol, 2013, 168(5):4744-4749. doi:10.1016/j.ijcard.2013.07.234
11 HEALEY J S, CONNOLLY S J, GOLD M R, et al. Subclinical atrial fibrillation and the risk of stroke[J]. N Engl J Med, 2012, 366(2):120-129. doi:10.1056/nejmoa1105575
12 PASSMAN R S, WEINBERG K M, FREHER M, et al. Accuracy of mode switch algorithms for detection of atrial tachyarrhythmias[J]. J Cardiovasc Electrophysiol, 2004, 15(7):773-777. doi:10.1046/j.1540-8167.2004.03537.x
13 安亚平,俞杉,郑志伟,等. 二维斑点追踪成像评价右室不同部位起搏对左室功能及同步性的影响[J]. 实用医学杂志, 2019,35(10):1659-1663. doi:10.3969/j.issn.1006-5725.2019.10.029
14 FANARI Z, HAMMAMI S, HAMMAMI M B, et al. The effects of right ventricular apical pacing with transvenous pacemaker and implantable cardioverter defibrillator on mitral and tricuspid regurgitation[J]. J Electrocardiol, 2015, 48(5):791-797. doi:10.1016/j.jelectrocard.2015.07.002
15 OLSEN F J, M?GELVANG R, JENSEN G B, et al. Relationship Between Left Atrial Functional Measures and Incident Atrial Fibrillation in the General Population: The Copenhagen City Heart Study[J]. JACC Cardiovasc Imaging, 2019, 12(6):981-989. doi:10.1016/j.jcmg.2017.12.016
16 SWEENEY M O, HELLKAMP A S, ELLENBOGEN K A, et al. Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction[J]. Circulation, 2003, 107(23):2932-2937. doi:10.1161/01.cir.0000072769.17295.b1
17 HUANG W, CHEN X, SU L, et al. A beginner's guide to permanent left bundle branch pacing[J]. Heart Rhythm, 2019, 16(12):1791-1796. doi:10.1016/j.hrthm.2019.06.016
18 JASTRZ?BSKI M, KIE?BASA G, CANO O, et al. Left bundle branch area pacing outcomes: the multicentre European MELOS study[J]. Eur Heart J, 2022, 43(40):4161-4173. doi:10.1093/eurheartj/ehac445
19 ZHU H, LI X, WANG Z, et al. New-onset atrial fibrillation following left bundle branch area pacing vs. right ventricular pacing: a two-centre prospective cohort study[J]. Europace, 2023, 25(1):121-129. doi:10.1093/europace/euac241
20 KHAN A A, BORIANI G, LIP G Y H. Are atrial high rate episodes (AHREs) a precursor to atrial fibrillation? [J]. Clin Res Cardiol, 2020, 109(4):409-416. doi:10.1007/s00392-019-01545-4
21 VITOLO M, IMBERTI J F, MAISANO A, et al. Device-detected atrial high rate episodes and the risk of stroke/thrombo-embolism and atrial fibrillation incidence: a systematic review and meta-analysis[J]. Eur J Intern Med, 2021, 92(16): 100-106. doi:10.1016/j.ejim.2021.05.038
22 SINHA S K, BHAGAT K, ASIF M, et al. Fragmented QRS as a Marker of Electrical Dyssynchrony to Predict Inter-Ventricular Conduction Defect by Subsequent Echocardiographic Assessment in Symptomatic Patients of Non-Ischemic Dilated Cardiomyopathy[J]. Cardiol Res, 2016, 7(4):140-145. doi:10.14740/cr495w
23 GLIKSON M, NIELSEN J C, KRONBORG M B, et al. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA) [J]. Rev Esp Cardiol (Engl Ed), 2022, 75(5):430. doi:10.1016/j.rec.2022.04.004
24 MEI Y, HAN R, CHENG L, et al. Assessment of Cardiac Function and Ventricular Mechanical Synchronization in Left Bundle Branch Area Pacing by Speckle Tracking and Three-Dimensional Echocardiography[J]. Am J Cardiol, 2023, 187:1-9. doi:10.1016/j.amjcard.2022.10.012
25 XU C, CHEN K, YU F, et al. Atrial Dyssynchrony: A New Predictor for Atrial High-Rate Episodes in Patients with Cardiac Resynchronization Therapy[J]. Cardiology, 2019, 144(1/2):18-26. doi:10.1159/000502541
Outlines

/