Feasibility of Left Bundle Branch Area Pacing Combined with Atrioventricular Node Ablation in Atrial Fibrillation Patients with Heart Failure

Background: Pacemaker implantation combined with atrioventricular node ablation (AVNA) could be a practical choice for atrial fibrillation (AF) patients with heart failure (HF). Left bundle branch area pacing (LBBaP) has been widely reported. Objectives: To explore the safety and efficacy of LBBaP c...

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Main Authors: Qi-Qi Jin, Cheng Zheng, Yao-Ji Wang, Jia-Xuan Lin, Dao-Zhu Wu, Jia-Feng Lin, Xue-Qiang Guan
Format: Article
Language:English
Published: MDPI AG 2022-10-01
Series:Journal of Cardiovascular Development and Disease
Subjects:
Online Access:https://www.mdpi.com/2308-3425/9/10/338
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author Qi-Qi Jin
Cheng Zheng
Yao-Ji Wang
Jia-Xuan Lin
Dao-Zhu Wu
Jia-Feng Lin
Xue-Qiang Guan
author_facet Qi-Qi Jin
Cheng Zheng
Yao-Ji Wang
Jia-Xuan Lin
Dao-Zhu Wu
Jia-Feng Lin
Xue-Qiang Guan
author_sort Qi-Qi Jin
collection DOAJ
description Background: Pacemaker implantation combined with atrioventricular node ablation (AVNA) could be a practical choice for atrial fibrillation (AF) patients with heart failure (HF). Left bundle branch area pacing (LBBaP) has been widely reported. Objectives: To explore the safety and efficacy of LBBaP combined with AVNA in AF patients with HF. Methods and results: Fifty-six AF patients with HF attempted LBBaP and AVNA from January 2019 to December 2020. Standard LBBaP was achieved in forty-six patients, and another ten received left ventricular septal pacing (LVSP). The cardiac function indexes and pacemaker parameters were evaluated at baseline, and we conducted a 1-month and 1-year follow-up. Result: At the time of implantation and 1-month and 1-year follow-up, QRS duration of LVSP group was longer than that of LBBaP group. The pacemaker parameters remained stable in both the LBBaP and LVSP groups. At 1-month and 1-year follow-up after LBBaP and AVNA, left ventricular ejection fraction, left ventricular end-diastolic diameter, and NYHA classification continued to improve. Baseline left ventricular ejection fraction and QRS duration change at implantation can predict the magnitude of improvement of left ventricular ejection fraction at 1-year after LBBaP. Baseline right atrial left-right diameter, the degree of tricuspid regurgitation, and interventricular septum thickness may be the factors affecting the success of LBBaP. Conclusion: LBBaP combined with AVNA is safe and effective for patients with AF and HF. Baseline right atrial left-right diameter, the degree of tricuspid regurgitation, and interventricular septum thickness may be the factors affecting the success of LBBaP.
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spelling doaj.art-4ab97bb4fc0042ce8ab7996bc6d901e32023-12-02T00:33:23ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252022-10-0191033810.3390/jcdd9100338Feasibility of Left Bundle Branch Area Pacing Combined with Atrioventricular Node Ablation in Atrial Fibrillation Patients with Heart FailureQi-Qi Jin0Cheng Zheng1Yao-Ji Wang2Jia-Xuan Lin3Dao-Zhu Wu4Jia-Feng Lin5Xue-Qiang Guan6Department of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Xueyuan Road No. 109, Wenzhou 325027, ChinaDepartment of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Xueyuan Road No. 109, Wenzhou 325027, ChinaDepartment of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Xueyuan Road No. 109, Wenzhou 325027, ChinaDepartment of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Xueyuan Road No. 109, Wenzhou 325027, ChinaDepartment of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Xueyuan Road No. 109, Wenzhou 325027, ChinaDepartment of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Xueyuan Road No. 109, Wenzhou 325027, ChinaDepartment of Cardiology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Xueyuan Road No. 109, Wenzhou 325027, ChinaBackground: Pacemaker implantation combined with atrioventricular node ablation (AVNA) could be a practical choice for atrial fibrillation (AF) patients with heart failure (HF). Left bundle branch area pacing (LBBaP) has been widely reported. Objectives: To explore the safety and efficacy of LBBaP combined with AVNA in AF patients with HF. Methods and results: Fifty-six AF patients with HF attempted LBBaP and AVNA from January 2019 to December 2020. Standard LBBaP was achieved in forty-six patients, and another ten received left ventricular septal pacing (LVSP). The cardiac function indexes and pacemaker parameters were evaluated at baseline, and we conducted a 1-month and 1-year follow-up. Result: At the time of implantation and 1-month and 1-year follow-up, QRS duration of LVSP group was longer than that of LBBaP group. The pacemaker parameters remained stable in both the LBBaP and LVSP groups. At 1-month and 1-year follow-up after LBBaP and AVNA, left ventricular ejection fraction, left ventricular end-diastolic diameter, and NYHA classification continued to improve. Baseline left ventricular ejection fraction and QRS duration change at implantation can predict the magnitude of improvement of left ventricular ejection fraction at 1-year after LBBaP. Baseline right atrial left-right diameter, the degree of tricuspid regurgitation, and interventricular septum thickness may be the factors affecting the success of LBBaP. Conclusion: LBBaP combined with AVNA is safe and effective for patients with AF and HF. Baseline right atrial left-right diameter, the degree of tricuspid regurgitation, and interventricular septum thickness may be the factors affecting the success of LBBaP.https://www.mdpi.com/2308-3425/9/10/338left bundle branch area pacingleft ventricular septal pacingatrioventricular node ablationatrial fibrillationheart failure
spellingShingle Qi-Qi Jin
Cheng Zheng
Yao-Ji Wang
Jia-Xuan Lin
Dao-Zhu Wu
Jia-Feng Lin
Xue-Qiang Guan
Feasibility of Left Bundle Branch Area Pacing Combined with Atrioventricular Node Ablation in Atrial Fibrillation Patients with Heart Failure
Journal of Cardiovascular Development and Disease
left bundle branch area pacing
left ventricular septal pacing
atrioventricular node ablation
atrial fibrillation
heart failure
title Feasibility of Left Bundle Branch Area Pacing Combined with Atrioventricular Node Ablation in Atrial Fibrillation Patients with Heart Failure
title_full Feasibility of Left Bundle Branch Area Pacing Combined with Atrioventricular Node Ablation in Atrial Fibrillation Patients with Heart Failure
title_fullStr Feasibility of Left Bundle Branch Area Pacing Combined with Atrioventricular Node Ablation in Atrial Fibrillation Patients with Heart Failure
title_full_unstemmed Feasibility of Left Bundle Branch Area Pacing Combined with Atrioventricular Node Ablation in Atrial Fibrillation Patients with Heart Failure
title_short Feasibility of Left Bundle Branch Area Pacing Combined with Atrioventricular Node Ablation in Atrial Fibrillation Patients with Heart Failure
title_sort feasibility of left bundle branch area pacing combined with atrioventricular node ablation in atrial fibrillation patients with heart failure
topic left bundle branch area pacing
left ventricular septal pacing
atrioventricular node ablation
atrial fibrillation
heart failure
url https://www.mdpi.com/2308-3425/9/10/338
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