Left bundle branch area pacing in patients with severe interventricular septal hypertrophy: A multicenter study assessing feasibility, safety, and outcomes of lumenless and stylet-driven leads

Background: There has been limited success using left bundle branch area pacing (LBBAP) in patients with severe interventricular septal hypertrophy (IVSH). Objective: This study assesses the feasibility, safety, and outcome of LBBAP in patients with severe IVSH. Methods: 19 adult patients with sever...

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Main Authors: Sanjai Pattu Valappil, MD, DM, Abhinav B. Anand, MD, DM, Anindya Ghosh, MD, DM, Krishnaswamy Subramanyan, MD, DM, Pramod Jaiswal, MD, DM, Krishnan Jayanthi, MD, DNB, Golla N. Prasad, MD, DNB, Tirupattur S. Srinath, MD, DNB, Shilpa Menon, MD, DM, Sharan Shreedhar, MD, Karthikeyan D, DMRD, DNB, Radiology, Velayudhan Bashi, MS, MCH, Justin Paul, MD, DNB, DM, Elangovan Elavarasi Manimegalai, MD, DM, Immanuel Sathiakumar Arunkumar, MD (General Medicine), DM (Cardiology), Sriram Veeraraghavan, MD, DM, Saran G. Kumar, BSc, Soli Rajaram Ramkumar, MD, DM, Raniya Palliyedath, MBBS, Shaima Hafeez, MBBS, Ulhas M. Pandurangi, MD, DM
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:Heart Rhythm O2
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666501825000832
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author Sanjai Pattu Valappil, MD, DM
Abhinav B. Anand, MD, DM
Anindya Ghosh, MD, DM
Krishnaswamy Subramanyan, MD, DM
Pramod Jaiswal, MD, DM
Krishnan Jayanthi, MD, DNB
Golla N. Prasad, MD, DNB
Tirupattur S. Srinath, MD, DNB
Shilpa Menon, MD, DM
Sharan Shreedhar, MD
Karthikeyan D, DMRD, DNB, Radiology
Velayudhan Bashi, MS, MCH
Justin Paul, MD, DNB, DM
Elangovan Elavarasi Manimegalai, MD, DM
Immanuel Sathiakumar Arunkumar, MD (General Medicine), DM (Cardiology)
Sriram Veeraraghavan, MD, DM
Saran G. Kumar, BSc
Soli Rajaram Ramkumar, MD, DM
Raniya Palliyedath, MBBS
Shaima Hafeez, MBBS
Ulhas M. Pandurangi, MD, DM
author_facet Sanjai Pattu Valappil, MD, DM
Abhinav B. Anand, MD, DM
Anindya Ghosh, MD, DM
Krishnaswamy Subramanyan, MD, DM
Pramod Jaiswal, MD, DM
Krishnan Jayanthi, MD, DNB
Golla N. Prasad, MD, DNB
Tirupattur S. Srinath, MD, DNB
Shilpa Menon, MD, DM
Sharan Shreedhar, MD
Karthikeyan D, DMRD, DNB, Radiology
Velayudhan Bashi, MS, MCH
Justin Paul, MD, DNB, DM
Elangovan Elavarasi Manimegalai, MD, DM
Immanuel Sathiakumar Arunkumar, MD (General Medicine), DM (Cardiology)
Sriram Veeraraghavan, MD, DM
Saran G. Kumar, BSc
Soli Rajaram Ramkumar, MD, DM
Raniya Palliyedath, MBBS
Shaima Hafeez, MBBS
Ulhas M. Pandurangi, MD, DM
author_sort Sanjai Pattu Valappil, MD, DM
collection DOAJ
description Background: There has been limited success using left bundle branch area pacing (LBBAP) in patients with severe interventricular septal hypertrophy (IVSH). Objective: This study assesses the feasibility, safety, and outcome of LBBAP in patients with severe IVSH. Methods: 19 adult patients with severe IVSH who underwent LBBAP were enrolled. Baseline patient characteristics, procedural data, and postprocedural results were collected. The feasibility of LBBAP in patients with severe IVSH using the lumenless leads (LLL) and stylet-driven leads (SDL) were analyzed. Results: 19 IVSH and 529 normal septal thickness (NST) patients underwent LBBAP. Implant success was achieved in 497 patients with NST (93.9%) and 14 patients with severe IVSH (73.6%). Among the 19 patients with severe IVSH, 7 patients underwent attempted LBBAP using LLL, with successful outcomes in 4 (57.1%). The remaining 12 patients underwent LBBAP with SDL, of which 10 were successful (83.3%). Mean septal thickness (20 ± 1.9 vs 21 ± 2.2), paced QRS duration (123 ± 17 vs 121 ± 9), and left ventricular activation time (LVAT) (75 ± 6 vs 74 ± 9) were comparable in the LLL and SDL groups. The lead thresholds (0.8 ± 0.3) remained stable over the mean follow-up duration of 36 ± 28.67 months without any lead-related complications. Conclusion: LBBAP in patients with severe IVSH is safe and feasible. Although the overall success rates in this subgroup were lower (73.6%) compared with patients with NST, this was not significantly different with the use of SDL (83.3%) (P = .15).
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spelling doaj-art-0dc3edaa6a284231a3f623ad4183ac8c2025-08-20T02:33:18ZengElsevierHeart Rhythm O22666-50182025-05-016558859710.1016/j.hroo.2025.02.018Left bundle branch area pacing in patients with severe interventricular septal hypertrophy: A multicenter study assessing feasibility, safety, and outcomes of lumenless and stylet-driven leadsSanjai Pattu Valappil, MD, DM0Abhinav B. Anand, MD, DM1Anindya Ghosh, MD, DM2Krishnaswamy Subramanyan, MD, DM3Pramod Jaiswal, MD, DM4Krishnan Jayanthi, MD, DNB5Golla N. Prasad, MD, DNB6Tirupattur S. Srinath, MD, DNB7Shilpa Menon, MD, DM8Sharan Shreedhar, MD9Karthikeyan D, DMRD, DNB, Radiology10Velayudhan Bashi, MS, MCH11Justin Paul, MD, DNB, DM12Elangovan Elavarasi Manimegalai, MD, DM13Immanuel Sathiakumar Arunkumar, MD (General Medicine), DM (Cardiology)14Sriram Veeraraghavan, MD, DM15Saran G. Kumar, BSc16Soli Rajaram Ramkumar, MD, DM17Raniya Palliyedath, MBBS18Shaima Hafeez, MBBS19Ulhas M. Pandurangi, MD, DM20Department of Cardiology, SRM Insititutes for Medical Science, Vadapalani, ChennaiSeth GS Medical College and KEM Hospital, Acharya Donde Marg, Parel, Mumbai, India; Address reprint requests and correspondence: Abhinav B. Anand, MD, DM, Department of Cardiology, Seth GS Medical College and KEM Hospital, Acharya Donde Marg, Parel, Mumbai—400012, India.Madras Medical Mission, Mogappair, Chennai, Tamil NaduDepartment of Cardiology, SRM Insititutes for Medical Science, Vadapalani, ChennaiDepartment of Cardiology, SRM Insititutes for Medical Science, Vadapalani, ChennaiDepartment of Cardiology, SRM Insititutes for Medical Science, Vadapalani, ChennaiDepartment of Cardiology, SRM Insititutes for Medical Science, Vadapalani, ChennaiDepartment of Cardiology, SRM Insititutes for Medical Science, Vadapalani, ChennaiDepartment of Cardiology, SRM Insititutes for Medical Science, Vadapalani, ChennaiDepartment of Cardiology, SRM Insititutes for Medical Science, Vadapalani, ChennaiDepartment of Radiology, SRM Insititutes for Medical Science, Vadapalani, ChennaiDepartment of Cardiothoracic Surgery SRM Insititutes for Medical Science, Vadapalani, ChennaiRajiv Gandhi Government General Hospital & Madras Medical College, ChennaiRajiv Gandhi Government General Hospital & Madras Medical College, ChennaiSugam Hospitals, Thiruvottiyur, ChennaiDr. Mehta’s hospitals, Global campus, Thiruverkadu, Chennai, Tamil NaduMadras Medical Mission, Mogappair, Chennai, Tamil NaduMadras Medical Mission, Mogappair, Chennai, Tamil NaduBristol Royal Infirmary, United KingdomSRM Medical College Hospital and Research Centre, SRM Nagar, Potheri, Chengalpattu, Tamil NaduMadras Medical Mission, Mogappair, Chennai, Tamil NaduBackground: There has been limited success using left bundle branch area pacing (LBBAP) in patients with severe interventricular septal hypertrophy (IVSH). Objective: This study assesses the feasibility, safety, and outcome of LBBAP in patients with severe IVSH. Methods: 19 adult patients with severe IVSH who underwent LBBAP were enrolled. Baseline patient characteristics, procedural data, and postprocedural results were collected. The feasibility of LBBAP in patients with severe IVSH using the lumenless leads (LLL) and stylet-driven leads (SDL) were analyzed. Results: 19 IVSH and 529 normal septal thickness (NST) patients underwent LBBAP. Implant success was achieved in 497 patients with NST (93.9%) and 14 patients with severe IVSH (73.6%). Among the 19 patients with severe IVSH, 7 patients underwent attempted LBBAP using LLL, with successful outcomes in 4 (57.1%). The remaining 12 patients underwent LBBAP with SDL, of which 10 were successful (83.3%). Mean septal thickness (20 ± 1.9 vs 21 ± 2.2), paced QRS duration (123 ± 17 vs 121 ± 9), and left ventricular activation time (LVAT) (75 ± 6 vs 74 ± 9) were comparable in the LLL and SDL groups. The lead thresholds (0.8 ± 0.3) remained stable over the mean follow-up duration of 36 ± 28.67 months without any lead-related complications. Conclusion: LBBAP in patients with severe IVSH is safe and feasible. Although the overall success rates in this subgroup were lower (73.6%) compared with patients with NST, this was not significantly different with the use of SDL (83.3%) (P = .15).http://www.sciencedirect.com/science/article/pii/S2666501825000832Left bundle area pacingInterventricular septal hypertrophyLumenless leadsStylet driven leadsAortic stenosisHypertrophic cardiomyopathy
spellingShingle Sanjai Pattu Valappil, MD, DM
Abhinav B. Anand, MD, DM
Anindya Ghosh, MD, DM
Krishnaswamy Subramanyan, MD, DM
Pramod Jaiswal, MD, DM
Krishnan Jayanthi, MD, DNB
Golla N. Prasad, MD, DNB
Tirupattur S. Srinath, MD, DNB
Shilpa Menon, MD, DM
Sharan Shreedhar, MD
Karthikeyan D, DMRD, DNB, Radiology
Velayudhan Bashi, MS, MCH
Justin Paul, MD, DNB, DM
Elangovan Elavarasi Manimegalai, MD, DM
Immanuel Sathiakumar Arunkumar, MD (General Medicine), DM (Cardiology)
Sriram Veeraraghavan, MD, DM
Saran G. Kumar, BSc
Soli Rajaram Ramkumar, MD, DM
Raniya Palliyedath, MBBS
Shaima Hafeez, MBBS
Ulhas M. Pandurangi, MD, DM
Left bundle branch area pacing in patients with severe interventricular septal hypertrophy: A multicenter study assessing feasibility, safety, and outcomes of lumenless and stylet-driven leads
Heart Rhythm O2
Left bundle area pacing
Interventricular septal hypertrophy
Lumenless leads
Stylet driven leads
Aortic stenosis
Hypertrophic cardiomyopathy
title Left bundle branch area pacing in patients with severe interventricular septal hypertrophy: A multicenter study assessing feasibility, safety, and outcomes of lumenless and stylet-driven leads
title_full Left bundle branch area pacing in patients with severe interventricular septal hypertrophy: A multicenter study assessing feasibility, safety, and outcomes of lumenless and stylet-driven leads
title_fullStr Left bundle branch area pacing in patients with severe interventricular septal hypertrophy: A multicenter study assessing feasibility, safety, and outcomes of lumenless and stylet-driven leads
title_full_unstemmed Left bundle branch area pacing in patients with severe interventricular septal hypertrophy: A multicenter study assessing feasibility, safety, and outcomes of lumenless and stylet-driven leads
title_short Left bundle branch area pacing in patients with severe interventricular septal hypertrophy: A multicenter study assessing feasibility, safety, and outcomes of lumenless and stylet-driven leads
title_sort left bundle branch area pacing in patients with severe interventricular septal hypertrophy a multicenter study assessing feasibility safety and outcomes of lumenless and stylet driven leads
topic Left bundle area pacing
Interventricular septal hypertrophy
Lumenless leads
Stylet driven leads
Aortic stenosis
Hypertrophic cardiomyopathy
url http://www.sciencedirect.com/science/article/pii/S2666501825000832
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