Feasibility and safety of left bundle branch area pacing for patients with stable coronary artery disease
AimsStable coronary artery disease (CAD) is a prevalent comorbidity among patients requiring pacemaker implantation. This comorbidity may have an impact on the safety and prognosis of traditional right ventricular pacing (RVP). Left bundle branch area pacing (LBBaP) is a new physiological pacing mod...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-11-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1246846/full |
| _version_ | 1797447833587023872 |
|---|---|
| author | Yu Shan Yu Shan Maoning Lin Maoning Lin Xia Sheng Xia Sheng Jiefang Zhang Jiefang Zhang Yaxun Sun Yaxun Sun Guosheng Fu Guosheng Fu Min Wang Min Wang |
| author_facet | Yu Shan Yu Shan Maoning Lin Maoning Lin Xia Sheng Xia Sheng Jiefang Zhang Jiefang Zhang Yaxun Sun Yaxun Sun Guosheng Fu Guosheng Fu Min Wang Min Wang |
| author_sort | Yu Shan |
| collection | DOAJ |
| description | AimsStable coronary artery disease (CAD) is a prevalent comorbidity among patients requiring pacemaker implantation. This comorbidity may have an impact on the safety and prognosis of traditional right ventricular pacing (RVP). Left bundle branch area pacing (LBBaP) is a new physiological pacing modality. Our aim was to investigate the feasibility and safety of LBBaP in patients with the stable CAD.MethodsThis study included 309 patients with symptomatic bradycardia who underwent LBBaP from September 2017 to October 2021. We included 104 patients with stable CAD (CAD group) and 205 patients without CAD (non-CAD group). Additionally, 153 stable CAD patients underwent RVP, and 64 stable CAD patients underwent His-bundle pacing (HBP) were also enrolled in this study. The safety and prognosis of LBBaP was assessed by comparing pacing parameters, procedure-related complications, and clinical events.ResultsDuring a follow-up period of 17.4 ± 5.3 months, the safety assessment revealed that the overall rates of procedure-related complications were similar between the stable CAD group and the non-CAD group (7.7% vs. 3.9%). Likewise, similar rates of heart failure hospitalization (HFH) (4.8% vs. 3.4%, stable CAD vs. non-CAD) and the primary composite outcome including death due to cardiovascular disease, HFH, or the necessity for upgrading to biventricular pacing (6.7% vs. 3.9%, stable CAD vs. non-CAD), were observed. In stable CAD patients, LBBaP demonstrated lower pacing thresholds and higher R wave amplitudes when compared to HBP. Additionally, LBBaP also had significantly lower occurrences of the primary composite outcome (6.7% vs. 19.6%, P = 0.003) and HFH (4.8% vs. 13.1%, P = 0.031) than RVP in stable CAD patients, particularly among patients with the higher ventricular pacing (VP) burden (>20% and >40%).ConclusionCompared with non-CAD patients, LBBaP was found to be attainable in stable CAD patients and exhibited comparable mid-term safety and prognosis. Furthermore, in the stable CAD population, LBBaP has demonstrated more stable pacing parameters than HBP, and better prognostic outcomes compared to RVP. |
| first_indexed | 2024-03-09T14:01:41Z |
| format | Article |
| id | doaj.art-28053a13a74944569090930da3fe98bd |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-09T14:01:41Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-28053a13a74944569090930da3fe98bd2023-11-30T07:19:55ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-11-011010.3389/fcvm.2023.12468461246846Feasibility and safety of left bundle branch area pacing for patients with stable coronary artery diseaseYu Shan0Yu Shan1Maoning Lin2Maoning Lin3Xia Sheng4Xia Sheng5Jiefang Zhang6Jiefang Zhang7Yaxun Sun8Yaxun Sun9Guosheng Fu10Guosheng Fu11Min Wang12Min Wang13Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaKey Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, ChinaDepartment of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaKey Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, ChinaDepartment of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaKey Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, ChinaDepartment of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaKey Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, ChinaDepartment of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaKey Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, ChinaDepartment of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaKey Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, ChinaDepartment of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, ChinaKey Laboratory of Cardiovascular Intervention and Regenerative Medicine of Zhejiang Province, Hangzhou, ChinaAimsStable coronary artery disease (CAD) is a prevalent comorbidity among patients requiring pacemaker implantation. This comorbidity may have an impact on the safety and prognosis of traditional right ventricular pacing (RVP). Left bundle branch area pacing (LBBaP) is a new physiological pacing modality. Our aim was to investigate the feasibility and safety of LBBaP in patients with the stable CAD.MethodsThis study included 309 patients with symptomatic bradycardia who underwent LBBaP from September 2017 to October 2021. We included 104 patients with stable CAD (CAD group) and 205 patients without CAD (non-CAD group). Additionally, 153 stable CAD patients underwent RVP, and 64 stable CAD patients underwent His-bundle pacing (HBP) were also enrolled in this study. The safety and prognosis of LBBaP was assessed by comparing pacing parameters, procedure-related complications, and clinical events.ResultsDuring a follow-up period of 17.4 ± 5.3 months, the safety assessment revealed that the overall rates of procedure-related complications were similar between the stable CAD group and the non-CAD group (7.7% vs. 3.9%). Likewise, similar rates of heart failure hospitalization (HFH) (4.8% vs. 3.4%, stable CAD vs. non-CAD) and the primary composite outcome including death due to cardiovascular disease, HFH, or the necessity for upgrading to biventricular pacing (6.7% vs. 3.9%, stable CAD vs. non-CAD), were observed. In stable CAD patients, LBBaP demonstrated lower pacing thresholds and higher R wave amplitudes when compared to HBP. Additionally, LBBaP also had significantly lower occurrences of the primary composite outcome (6.7% vs. 19.6%, P = 0.003) and HFH (4.8% vs. 13.1%, P = 0.031) than RVP in stable CAD patients, particularly among patients with the higher ventricular pacing (VP) burden (>20% and >40%).ConclusionCompared with non-CAD patients, LBBaP was found to be attainable in stable CAD patients and exhibited comparable mid-term safety and prognosis. Furthermore, in the stable CAD population, LBBaP has demonstrated more stable pacing parameters than HBP, and better prognostic outcomes compared to RVP.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1246846/fullleft bundle branch area pacing (LBBaP)stable coronary artery diseasepacing parametersheart failure hospitalization (HFH)safety |
| spellingShingle | Yu Shan Yu Shan Maoning Lin Maoning Lin Xia Sheng Xia Sheng Jiefang Zhang Jiefang Zhang Yaxun Sun Yaxun Sun Guosheng Fu Guosheng Fu Min Wang Min Wang Feasibility and safety of left bundle branch area pacing for patients with stable coronary artery disease Frontiers in Cardiovascular Medicine left bundle branch area pacing (LBBaP) stable coronary artery disease pacing parameters heart failure hospitalization (HFH) safety |
| title | Feasibility and safety of left bundle branch area pacing for patients with stable coronary artery disease |
| title_full | Feasibility and safety of left bundle branch area pacing for patients with stable coronary artery disease |
| title_fullStr | Feasibility and safety of left bundle branch area pacing for patients with stable coronary artery disease |
| title_full_unstemmed | Feasibility and safety of left bundle branch area pacing for patients with stable coronary artery disease |
| title_short | Feasibility and safety of left bundle branch area pacing for patients with stable coronary artery disease |
| title_sort | feasibility and safety of left bundle branch area pacing for patients with stable coronary artery disease |
| topic | left bundle branch area pacing (LBBaP) stable coronary artery disease pacing parameters heart failure hospitalization (HFH) safety |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1246846/full |
| work_keys_str_mv | AT yushan feasibilityandsafetyofleftbundlebranchareapacingforpatientswithstablecoronaryarterydisease AT yushan feasibilityandsafetyofleftbundlebranchareapacingforpatientswithstablecoronaryarterydisease AT maoninglin feasibilityandsafetyofleftbundlebranchareapacingforpatientswithstablecoronaryarterydisease AT maoninglin feasibilityandsafetyofleftbundlebranchareapacingforpatientswithstablecoronaryarterydisease AT xiasheng feasibilityandsafetyofleftbundlebranchareapacingforpatientswithstablecoronaryarterydisease AT xiasheng feasibilityandsafetyofleftbundlebranchareapacingforpatientswithstablecoronaryarterydisease AT jiefangzhang feasibilityandsafetyofleftbundlebranchareapacingforpatientswithstablecoronaryarterydisease AT jiefangzhang feasibilityandsafetyofleftbundlebranchareapacingforpatientswithstablecoronaryarterydisease AT yaxunsun feasibilityandsafetyofleftbundlebranchareapacingforpatientswithstablecoronaryarterydisease AT yaxunsun feasibilityandsafetyofleftbundlebranchareapacingforpatientswithstablecoronaryarterydisease AT guoshengfu feasibilityandsafetyofleftbundlebranchareapacingforpatientswithstablecoronaryarterydisease AT guoshengfu feasibilityandsafetyofleftbundlebranchareapacingforpatientswithstablecoronaryarterydisease AT minwang feasibilityandsafetyofleftbundlebranchareapacingforpatientswithstablecoronaryarterydisease AT minwang feasibilityandsafetyofleftbundlebranchareapacingforpatientswithstablecoronaryarterydisease |