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Left bundle branch area versus conventional pacing after transcatheter valve implant for aortic stenosis: the LATVIA study.
Dell'Era, Gabriele; Baroni, Matteo; Frontera, Antonio; Ghiglieno, Chiara; Carbonaro, Marco; Penela, Diego; Romano, Carmine; Giordano, Federica; Del Monaco, Guido; Galimberti, Paola; Mazzone, Patrizio; Patti, Giuseppe.
Afiliación
  • Dell'Era G; Clinica Cardiologica, Dipartimento Toraco-Cardio-Vascolare, Ospedale Maggiore della Carità, Novara.
  • Baroni M; Cardiologia 3. A. De' Gasperis Cardio Center, ASST GOM Niguarda Hospital.
  • Frontera A; Cardiologia 3. A. De' Gasperis Cardio Center, ASST GOM Niguarda Hospital.
  • Ghiglieno C; Clinica Cardiologica, Dipartimento Toraco-Cardio-Vascolare, Ospedale Maggiore della Carità, Novara.
  • Carbonaro M; Cardiologia 3. A. De' Gasperis Cardio Center, ASST GOM Niguarda Hospital.
  • Penela D; Humanitas Research Hospital, Rozzano, Milan.
  • Romano C; Università del Piemonte Orientale Amedeo Avogadro, Italy.
  • Giordano F; Cardiologia 3. A. De' Gasperis Cardio Center, ASST GOM Niguarda Hospital.
  • Del Monaco G; Humanitas Research Hospital, Rozzano, Milan.
  • Galimberti P; Humanitas Research Hospital, Rozzano, Milan.
  • Mazzone P; Cardiologia 3. A. De' Gasperis Cardio Center, ASST GOM Niguarda Hospital.
  • Patti G; Clinica Cardiologica, Dipartimento Toraco-Cardio-Vascolare, Ospedale Maggiore della Carità, Novara.
J Cardiovasc Med (Hagerstown) ; 25(6): 450-456, 2024 Jun 01.
Article en En | MEDLINE | ID: mdl-38625833
ABSTRACT

BACKGROUND:

Atrioventricular block (AVB) is a frequent complication in patients undergoing transcatheter aortic valve implantation (TAVI). Right apex ventricular pacing (RVP) represents the standard treatment but may induce cardiomyopathy over the long term. Left bundle branch area pacing (LBBAP) is a promising alternative, minimizing the risk of desynchrony. However, available evidence with LBBAP after TAVI is still low.

OBJECTIVE:

To assess the feasibility and safety of LBBAP for AVB post-TAVI compared with RVP.

METHODS:

Consecutive patients developing AVB early after TAVI were enrolled between 1 January 2022 and 31 December 2022 at three high-volume hospitals and received LBBAP or RVP. Data on procedure and at short-term follow-up (at least 3 months) were collected.

RESULTS:

A total of 38 patients (61% men, mean age 83 ±â€Š6 years) were included; 20 patients (53%) received LBBAP. Procedural success was obtained in all patients according to chosen pacing strategy. Electrical pacing performance at implant and after a mean follow-up of 4.2 ±â€Š2.8 months was clinically equivalent for both pacing modalities. In the LBBAP group, procedural time was longer (70 ±â€Š17 versus 58 ±â€Š15 min in the RVP group, P  = 0.02) and paced QRS was shorter (120 ±â€Š19 versus 155 ±â€Š12 ms at implant, P  < 0.001; 119 ±â€Š18 versus 157 ±â€Š9 ms at follow-up, P  < 0.001). Complication rates did not differ between the two groups.

CONCLUSION:

In patients with AVB after TAVI, LBBAP is feasible and safe, resulting in a narrow QRS duration, either acutely and during the follow-up, compared with RVP. Further studies are needed to evaluate if LBBAP reduces pacing-induced cardiomyopathy in this clinical setting.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Fascículo Atrioventricular / Estimulación Cardíaca Artificial / Estudios de Factibilidad / Bloqueo Atrioventricular / Reemplazo de la Válvula Aórtica Transcatéter Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: J Cardiovasc Med (Hagerstown) Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Fascículo Atrioventricular / Estimulación Cardíaca Artificial / Estudios de Factibilidad / Bloqueo Atrioventricular / Reemplazo de la Válvula Aórtica Transcatéter Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: Europa Idioma: En Revista: J Cardiovasc Med (Hagerstown) Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article
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