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

D-PO04-104 - Preliminary Study On Pacing Of Left Bundle Branch In Children (ID 441)

 C. Dai: Nothing relevant to disclose.


Background: Left bundle branch area pacing (LBBAP) has emerged as an alternative method for delivering physiological pacing to achieve electrical synchrony of the left ventricle. There has not been any related data reported in children.
Objective: To explore the safety and effectiveness of left bundle branch area pacing (LBBAP) in children.
Methods: Clinical data, pacing electrocardiogram and parameters of 6 patients who underwent permanent pacemaker implantation in LBBAP from January 2019 to June in the department of pediatric cardiology of An Zhen Hospital were retrospectively analyzed.
Results: Among the 6 patients, there were 5 patients with III° atrioventricular block, and 1 patient with cardiac dysfunction after right ventricular apical pacing. The average age was 6.71±2.13 years old and the average weight was 19.78±4.41 kg. Cardiac function was decreased in one patient and normal in the other five patients. Left ventricular end diastolic diameter Z value was 1.85±0.65. V1 lead showed right bundle branch block in pacing electrocardiogram. QRS wave duration was 111.3±20.3 ms. Pacing threshold was 0.85±0.3 V. The perception was 15±4.3 mV and the impedance was 717±73Ω. P potential was recorded in 3 cases. The average stimulus to left ventricular activation time was 56±4.9 ms and it remained constant at different output voltages. Postoperative echocardiography revealed that the electrodes were located near the endocardium of the left ventricular septum. No complications such as myocardial perforation and electrode dislocation occurred during follow-up. The pacing threshold, perception and impedance were good. The patient with low LVEF returned to normal 3 days after LBBAP. The LVEDD Z value decreased to (1.13±0.34) 3 months after operation, which was significantly lower than that before operation(p<0.05).
Conclusion: Left bundle branch pacing in children can achieve narrow QRS pacing, close to physiological pacing, pacing parameters are stable. It can quickly and effectively correct left ventricular enlargement caused by long-term bradycardia and cardiac dysfunction and cardiac enlargement caused by long-term right ventricular apical pacing. Left bundle branch pacing is safe and feasible for older children.