Cardiovascular Implantable Electronic Devices -> Leads & Electrodes: -> Technology D-MP07 - The A Through Z for CIEDs (ID 55) Moderated ePoster

D-MP07-03 - Feasibility And Safety Of Left Bundle Branch Pacing (ID 1487)

 W. Huang: Nothing relevant to disclose.


Background: His bundle pacing (HBP) is a physiological pacing method but often with relative high threshold and low R wave amplitude in patients with His-Purkinje conduction disease. To settle these problems, left bundle branch pacing (LBBP) emerged.
Objective: To evaluate the feasibility and safety of LBBP with a large sample size and a long-term follow up.
Methods: From April 2017 to January 2019, consecutive pacemaker-indicated patients without intraventricular conduction delay were enrolled. Patients were divided into three groups (Figure 1A). Electrocardiograms, pacing parameters, echocardiographic measurements and complications were evaluated at implant and follow-up.
Results: A total of 474 patients aged 69.35±11.45 years old were included, LBBP was successfully performed in 97.3% (461/474) of patients. Pacing threshold at implant was 0.54±0.17 V @ 0.5 ms and remained stable at follow-up of 6 months (0.65±0.21 V @ 0.5 ms) as well as R wave amplitude (Figure 1B). LBBB was corrected by LBBP in group 1 (intrinsic QRSd 172.54±15.11 ms vs. paced QRSd 119.29±19.84 ms, P<0.001). Compared with baseline, LVEF greatly improved at six-month follow-up (56.53±15.98% vs. 61.74±12.23%, P<0.001), especially significant in group 1 (Figure 1C). Meanwhile, LVEDd also improved during follow-up (Figure 1D). Acute or chronic complications happened in 16 (3.47%) patients, 4 of them had increasing pacing threshold, 4 got loss of capture during follow-up and others had lead or procedure related complications (Figure 1B).
Conclusion: Permanent LBBP lead to a stable threshold, high success rate and improved left ventricular function with few complications.