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Archivos de cardiología de México
On-line version ISSN 1665-1731Print version ISSN 1405-9940
Abstract
ALONSO FERNANDEZ, Pau et al. Clinical, hemodynamic and biochemical improvement related to left bundle branch area pacing. Arch. Cardiol. Méx. [online]. 2023, vol.93, n.1, pp.44-52. Epub Feb 24, 2023. ISSN 1665-1731. https://doi.org/10.24875/acm.21000355.
Background:
Right ventricular pacing is associated with risk of heart failure and left ventricular dysfunction. Left bundle branch area pacing (LBBP) has emerged as an alternative method for delivering physiological pacing. The effect of LBBP on N-terminal pro-brain natriuretic peptide (NT-proBNP) has not been investigated.
Method:
Finally, 50 patients referred for pacemaker implantation were included. LBBP was performed as described previously by Huang et al. Transthoracic echocardiogram and NT-proBNP were performed before and four weeks after the procedure.
Results:
50 patients were analyzed. There were not differences between ventricular thresholds during the procedure and 3 months later, LBBP significantly reduced QRS complex duration (148 ± 21 vs. 107 ± 11 ms; p = 0.029). LBBP significantly improved NYHA functional class and reduced NT-proBNP concentration (2888.2 ± 510 vs. 1181 ± 130 pg/ml; p = 0.04). In patients showing left ventricular ejection fraction (LVEF) < 50% and ventricular desynchrony LBBP showed a significant LVEF increase (40.2 ± 7 vs. 55.2 ± 7%; p < 0.001).
Conclusions:
LBBP was feasible and safe in most of patients. LBBP was associated with reduction in QRS width and with increase in LVEF in patients with ventricular desynchrony, while in patients with normal LVEF it remained unchanged during follow-up.
Keywords : Left bundle branch pacing; Heart Failure; Ventricular pacing.