Feasibility and Safety of Left Bundle Branch Pacing for Advance Aged Patients: A Multicenter Comparative Study
Background: Left bundle branch pacing (LBBP) has been shown to be a safe and effective means to achieve physiological pacing. However, elderly patients have increased risks from invasive procedures and the risk of LBBP in elderly patients is not known. We aimed to investigate the safety and efficacy...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
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Frontiers Media S.A.
2021-07-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.661885/full |
| _version_ | 1818652511852036096 |
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| author | Zhongyuan Ren Binni Cai Songyun Wang Peng Jia Yang Chen Rong Guo Hailing Li Jun Zhang Jing Xiong Jingying Zhang Haotian Yang Xiang Li Yawei Xu Xueying Chen Dongdong Zhao |
| author_facet | Zhongyuan Ren Binni Cai Songyun Wang Peng Jia Yang Chen Rong Guo Hailing Li Jun Zhang Jing Xiong Jingying Zhang Haotian Yang Xiang Li Yawei Xu Xueying Chen Dongdong Zhao |
| author_sort | Zhongyuan Ren |
| collection | DOAJ |
| description | Background: Left bundle branch pacing (LBBP) has been shown to be a safe and effective means to achieve physiological pacing. However, elderly patients have increased risks from invasive procedures and the risk of LBBP in elderly patients is not known. We aimed to investigate the safety and efficacy of LBBP in elderly patients >80 years of age.Methods: From December 2017 to June 2019, 346 consecutive patients with symptomatic bradycardia, 184 patients under 80 years of age and 162 over 80 years, were included and underwent LBBP. The safety and prognosis of LBBP were comparatively evaluated by measured pacing parameters, periprocedural complications, and follow-up clinical events.Results: Compared with the younger, the elderly group had worse baseline cardiac and renal function. LBBP was achieved successfully in both groups with comparable fluoroscopic time and paced QRS duration (110.0 [102.0, 118.0] ms for the young vs. 110.0 [100.0, 120.0] ms for the elderly, P = 0.874). Through a follow-up of 20.0 ± 6.1 months, pacing parameters were stable while higher threshold and impedance were observed in the elderly group. In the evaluation of safety, overall procedure-related complication rates were comparable (4.4 vs. 3.8%, young vs. elderly). For prognosis, similar rates of major adverse cardiocerebrovascular events (7.1 vs. 11.9%, young vs. elderly) were observed.Conclusions: Compared to younger patients, LBBP could achieve physiological pacing in patients over 80 with comparable midterm safety and prognosis. Long-term safety and benefits of LBBP, however, necessitate further evaluation. |
| first_indexed | 2024-12-17T02:23:11Z |
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| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-17T02:23:11Z |
| publishDate | 2021-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-0d849a3153f240ac995ac9f4be254f842022-12-21T22:07:12ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-07-01810.3389/fcvm.2021.661885661885Feasibility and Safety of Left Bundle Branch Pacing for Advance Aged Patients: A Multicenter Comparative StudyZhongyuan Ren0Binni Cai1Songyun Wang2Peng Jia3Yang Chen4Rong Guo5Hailing Li6Jun Zhang7Jing Xiong8Jingying Zhang9Haotian Yang10Xiang Li11Yawei Xu12Xueying Chen13Dongdong Zhao14Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, ChinaDepartment of Cardiology, Renmin Hospital of Wuhan University, Wuhan University School of Medicine, Wuhan, ChinaDepartment of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardiology, National Clinical Research Center for Interventional Medicine, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital of Fudan University, Shanghai, ChinaDepartment of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, ChinaBackground: Left bundle branch pacing (LBBP) has been shown to be a safe and effective means to achieve physiological pacing. However, elderly patients have increased risks from invasive procedures and the risk of LBBP in elderly patients is not known. We aimed to investigate the safety and efficacy of LBBP in elderly patients >80 years of age.Methods: From December 2017 to June 2019, 346 consecutive patients with symptomatic bradycardia, 184 patients under 80 years of age and 162 over 80 years, were included and underwent LBBP. The safety and prognosis of LBBP were comparatively evaluated by measured pacing parameters, periprocedural complications, and follow-up clinical events.Results: Compared with the younger, the elderly group had worse baseline cardiac and renal function. LBBP was achieved successfully in both groups with comparable fluoroscopic time and paced QRS duration (110.0 [102.0, 118.0] ms for the young vs. 110.0 [100.0, 120.0] ms for the elderly, P = 0.874). Through a follow-up of 20.0 ± 6.1 months, pacing parameters were stable while higher threshold and impedance were observed in the elderly group. In the evaluation of safety, overall procedure-related complication rates were comparable (4.4 vs. 3.8%, young vs. elderly). For prognosis, similar rates of major adverse cardiocerebrovascular events (7.1 vs. 11.9%, young vs. elderly) were observed.Conclusions: Compared to younger patients, LBBP could achieve physiological pacing in patients over 80 with comparable midterm safety and prognosis. Long-term safety and benefits of LBBP, however, necessitate further evaluation.https://www.frontiersin.org/articles/10.3389/fcvm.2021.661885/fullphysiological pacingleft bundle branch pacingelderlysymptomatic bradycardiasafety |
| spellingShingle | Zhongyuan Ren Binni Cai Songyun Wang Peng Jia Yang Chen Rong Guo Hailing Li Jun Zhang Jing Xiong Jingying Zhang Haotian Yang Xiang Li Yawei Xu Xueying Chen Dongdong Zhao Feasibility and Safety of Left Bundle Branch Pacing for Advance Aged Patients: A Multicenter Comparative Study Frontiers in Cardiovascular Medicine physiological pacing left bundle branch pacing elderly symptomatic bradycardia safety |
| title | Feasibility and Safety of Left Bundle Branch Pacing for Advance Aged Patients: A Multicenter Comparative Study |
| title_full | Feasibility and Safety of Left Bundle Branch Pacing for Advance Aged Patients: A Multicenter Comparative Study |
| title_fullStr | Feasibility and Safety of Left Bundle Branch Pacing for Advance Aged Patients: A Multicenter Comparative Study |
| title_full_unstemmed | Feasibility and Safety of Left Bundle Branch Pacing for Advance Aged Patients: A Multicenter Comparative Study |
| title_short | Feasibility and Safety of Left Bundle Branch Pacing for Advance Aged Patients: A Multicenter Comparative Study |
| title_sort | feasibility and safety of left bundle branch pacing for advance aged patients a multicenter comparative study |
| topic | physiological pacing left bundle branch pacing elderly symptomatic bradycardia safety |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.661885/full |
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