Cardiovascular Implantable Electronic Devices -> Bradycardia Devices: -> Device Technology D-PO02 - Poster Session II (ID 47) Poster

D-PO02-101 - Electromechanical Synchronization Between His Bundle Pacing, Left Bundle Branch Pacing And Conventional Right Ventricular Pacing In Atrioventricular Block (ID 1015)

 X. Chen: Nothing relevant to disclose.


Background: The relationship between electrical and mechanical synchronization in LBBP has not been well established.
Objective: To compare electromechanical ventricular synchronization when pacing from different sites.
Methods: Twenty patients with complete AVB indicated for dual-chamber pacemaker implantation were included. All the patients received unipolar pacing at different sites including RVAP, RVSP, HBP, LBBP and RVSPring by the lead together with the sheath during implantation procedure. The paced QRS durations and echocardiogram parameters including LVEF, LVEDV,LVESV, TS-12-SD were collected and compared among intrinsic rhythm and pacing at different sites.
Results: As compared with RVAP or RVSP, paced QRSd was significantly different during HBP or LBBP, respectively(p<0.05). QRSd of RVSPring was also significantly different to RVAP(p<0.001). As for LVEDD, LVESD and LVEF, the difference was not significant among these different pacing sites. Both TS-12-SD and IVMD were significantly different between LBBP and RVAP(p=0.006,p<0.001) or RVSP(p=0.030 , p<0.001). There were no significant difference of QRSd and TS-12-SD between LBBP and HBP(p>0.05) while IVMD was significantly different between these two pacing sites(p<0.001). IVMD was negative in LBBP showing earlier LV activation than RV.
Conclusion: Similar to HBP, LBBP provided narrower QRSd and better mechanical left ventricular synchrony estimated by TS-12-SD than conventional RV pacing (RVAP or RVSP). While IVMD was significantly different during HBP, LBBP, RVAP and RVSP. IVMD was negative in LBBP showing earlier LV activation than RV, which was consistent with the RBBB pattern of paced QRS during LBBP.