Consecutive Experience with Left Bundle Branch Area Pacing in a High-Volume Australian Centre.
Heart Lung Circ
; 32(8): 993-999, 2023 Aug.
Article
in En
| MEDLINE
| ID: mdl-37236845
ABSTRACT
INTRODUCTION:
Left-bundle branch area pacing (LBBAP) is a relatively new technique for conduction system pacing. Australian safety and efficacy data is currently lacking. We aim to evaluate the learning curve, medium-term safety, and lead performance in a high-volume Australian setting.METHODS:
We performed a retrospective cohort study of 200 consecutive LBBAP procedures performed by a single operator at two centres between January 2019 and May 2020. Left bundle branch area pacing was performed predominantly via left subclavian access using a 69 cm Medtronic SelectSecure 3830 pacing lead and a preformed non-steerable C315-His sheath. Procedural success was defined as evidence of left septal or left bundle branch area capture as evidenced by a right bundle branch block-like paced morphology. Procedural characteristics, and follow-up (including lead performance) data were collected. Procedural efficiency over time, as well as safety data, were collected.RESULTS:
Median age was 78.26 years (interquartile range [IQR] 71-85), 37% were female. Atrial fibrillation was present in 22%. The left ventricular ejection fraction <50% in 24%, atrioventricular (AV) block was present in 43.5%, left bundle branch block in 22.5% and right bundle branch block in 24.5%. Acute procedural success was 91.5%. Implant threshold was 0.6V @ 0.5 ms, and 0.75V @ 0.5 ms at 11.9 months of follow-up. The QRS was significant reduced (baseline 134 ms vs implant 114 ms, p<0.001) There was a reduction in procedural time and X-ray dose over the course of the study. There were no complications specific to LBBAP.CONCLUSION:
LBBAP appears to be a safe and effective pacing strategy. The QRS duration was significantly reduced compared to baseline. There appears to be an early learning curve with LBBAP.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Bundle-Branch Block
/
Atrioventricular Block
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Oceania
Language:
En
Journal:
Heart Lung Circ
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2023
Type:
Article
Affiliation country:
Australia