Cardiovascular Implantable Electronic Devices -> Leads & Electrodes: -> Implantation D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-102 - Single Center Experience Of Left Bundle Branch Pacing: The Pro’S And Con’S (ID 439)

 V. Ravi: Nothing relevant to disclose.


Background: Left Bundle Branch Pacing (LBBP) has recently emerged as an alternative mode of conduction system pacing with some promise. However, limited world data exists on the advantages and complications associated with LBBP.
Objective: We sought to analyze the Rush conduction system pacing registry on LBBP to assess the success rates and peri-procedural complications associated with LBBP
Methods: All patients (pts) with indication for pacing (PPM) or cardiac resynchronization therapy (CRT) that underwent LBBP for various reasons between June 2018 to November 2019 were included for analysis.
Results: A total of 45 pts underwent successful LBBP of 47 attempted cases with a success rate of 96%. Reasons for LBBP were divided into 4 groups (Figure 1). At implant, the average R-waves were 10.2 ± 5.2 mV, impedance was 656 ± 196 ohms and LBB capture threshold was 0.6 ± 0.2 V @ 1ms. A LBB potential was noted in 38 % of cases, with potential to QRS of 23 ± 5ms and the average LVAT was 69.6 ± 11. During an average follow-up of 141 ± 128 days, the LBB capture threshold remained stable at 0.66 ± 0.61 (p=0.546) (Figure 1). Baseline QRSd was 146 ± 40ms and LBBP QRSd was 123 ± 13ms (p=<0.001), while in pts with bundle branch block (n= 24), the QRSd decreased from 161 ± 23ms to 126 ± 11 ms (p= <0.001) (Figure 1). Among patients with a known cardiomyopathy LVEF improved from 27.8 ± 13.5 % to 39.4 ± 16.4% (p= 0.003). A total of 7 (15.6%) lead related complications were noted in follow-up (Figure 1).
Conclusion: LBBP can be achieved with a high success rate and demonstrates low capture threshold with an improved LVEF in follow-up. However, lead related complications can be more frequent.