Myocardial work parameters in left bundle branch area pacing versus other pacing techniques: a systematic review and aggregate comparative analysis
Cardiac conduction disease often necessitates permanent pacemaker implantation. While right ventricular pacing (RVP) effectively treats bradycardia, it may lead to adverse cardiac remodeling and heart failure. Left bundle branch area pacing (LBBAP) has emerged as an alternative, potentially preservi...
Saved in:
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-06-01
|
| Series: | International Journal of Cardiology: Heart & Vasculature |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906725000867 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849727768660541440 |
|---|---|
| author | Raffaella Mistrulli Sara Gharehdaghi Arthur Iturriagagoitia Elayne Kelen de Oliveira Lucio Addeo Stefano Valcher Sara Corradetti Michele Mattia Viscusi Peter Peytchev Ward A. Heggermont Marc Vanderheyden Emanuele Barbato Guy Van Camp Martin Penicka |
| author_facet | Raffaella Mistrulli Sara Gharehdaghi Arthur Iturriagagoitia Elayne Kelen de Oliveira Lucio Addeo Stefano Valcher Sara Corradetti Michele Mattia Viscusi Peter Peytchev Ward A. Heggermont Marc Vanderheyden Emanuele Barbato Guy Van Camp Martin Penicka |
| author_sort | Raffaella Mistrulli |
| collection | DOAJ |
| description | Cardiac conduction disease often necessitates permanent pacemaker implantation. While right ventricular pacing (RVP) effectively treats bradycardia, it may lead to adverse cardiac remodeling and heart failure. Left bundle branch area pacing (LBBAP) has emerged as an alternative, potentially preserving myocardial function. Non-invasive myocardial work (MW) assessment provides valuable insights into left ventricular systolic function, energetics, and efficiency. This study systematically reviewed and analyzed MW parameters, comparing LBBAP to RVP and His bundle pacing (HBP). A meta-analysis of 241 patients across five studies examined four MW parameters—Global Work Index (GWI), Global Constructive Work (GCW), Global Wasted Work (GWW), and Global Work Efficiency (GWE)—at baseline, post-implantation, and last follow-up (median: 180 days, IQR: 7–360 days). At baseline, MW parameters were similar between LBBAP and RVP. Post-implantation, LBBAP preserved MW more effectively, showing significantly higher GWI than RVP (2250.0 ± 400.0 vs. 1600.0 ± 300.0 mmHg%, p = 0.027), a difference that remained significant at follow-up (p = 0.035). GWE was also significantly higher at follow-up (p = 0.011), while GCW and GWW showed no significant differences. MW parameters did not differ significantly between LBBAP and HBP (all p-values >0.05). These findings suggest that LBBAP provides superior MW preservation compared to RVP, with significant benefits in GWI and GWE, while demonstrating comparable performance to HBP. |
| format | Article |
| id | doaj-art-ae07f783fdd94a61955fcb8cf0818b44 |
| institution | DOAJ |
| issn | 2352-9067 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj-art-ae07f783fdd94a61955fcb8cf0818b442025-08-20T03:09:45ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672025-06-015810168310.1016/j.ijcha.2025.101683Myocardial work parameters in left bundle branch area pacing versus other pacing techniques: a systematic review and aggregate comparative analysisRaffaella Mistrulli0Sara Gharehdaghi1Arthur Iturriagagoitia2Elayne Kelen de Oliveira3Lucio Addeo4Stefano Valcher5Sara Corradetti6Michele Mattia Viscusi7Peter Peytchev8Ward A. Heggermont9Marc Vanderheyden10Emanuele Barbato11Guy Van Camp12Martin Penicka13Department of Clinical and Molecular Medicine, Sapienza University of Rome 00189 Rome, Italy; Cardiovascular Center Aalst, OLV-Clinic, B-9300 Aalst, BelgiumCardiovascular Center Aalst, OLV-Clinic, B-9300 Aalst, Belgium; Semmelweiss University, Budapest, Hungary; Gottsegen György National Cardiovascular Institute, Budapest, HungaryCardiovascular Center Aalst, OLV-Clinic, B-9300 Aalst, BelgiumCardiovascular Center Aalst, OLV-Clinic, B-9300 Aalst, Belgium; University of Naples Federico II, Advanced Biomedical Sciences, Naples, ItalyCardiovascular Center Aalst, OLV-Clinic, B-9300 Aalst, Belgium; University of Naples Federico II, Advanced Biomedical Sciences, Naples, ItalyCardiovascular Center Aalst, OLV-Clinic, B-9300 Aalst, Belgium; Humanitas University, Milan, ItalyDepartment of Clinical and Molecular Medicine, Sapienza University of Rome 00189 Rome, Italy; Cardiovascular Center Aalst, OLV-Clinic, B-9300 Aalst, BelgiumCardiovascular Center Aalst, OLV-Clinic, B-9300 Aalst, Belgium; University of Naples Federico II, Advanced Biomedical Sciences, Naples, ItalyCardiovascular Center Aalst, OLV-Clinic, B-9300 Aalst, BelgiumCardiovascular Center Aalst, OLV-Clinic, B-9300 Aalst, BelgiumCardiovascular Center Aalst, OLV-Clinic, B-9300 Aalst, BelgiumDepartment of Clinical and Molecular Medicine, Sapienza University of Rome 00189 Rome, ItalyCardiovascular Center Aalst, OLV-Clinic, B-9300 Aalst, BelgiumCardiovascular Center Aalst, OLV-Clinic, B-9300 Aalst, BelgiumCardiac conduction disease often necessitates permanent pacemaker implantation. While right ventricular pacing (RVP) effectively treats bradycardia, it may lead to adverse cardiac remodeling and heart failure. Left bundle branch area pacing (LBBAP) has emerged as an alternative, potentially preserving myocardial function. Non-invasive myocardial work (MW) assessment provides valuable insights into left ventricular systolic function, energetics, and efficiency. This study systematically reviewed and analyzed MW parameters, comparing LBBAP to RVP and His bundle pacing (HBP). A meta-analysis of 241 patients across five studies examined four MW parameters—Global Work Index (GWI), Global Constructive Work (GCW), Global Wasted Work (GWW), and Global Work Efficiency (GWE)—at baseline, post-implantation, and last follow-up (median: 180 days, IQR: 7–360 days). At baseline, MW parameters were similar between LBBAP and RVP. Post-implantation, LBBAP preserved MW more effectively, showing significantly higher GWI than RVP (2250.0 ± 400.0 vs. 1600.0 ± 300.0 mmHg%, p = 0.027), a difference that remained significant at follow-up (p = 0.035). GWE was also significantly higher at follow-up (p = 0.011), while GCW and GWW showed no significant differences. MW parameters did not differ significantly between LBBAP and HBP (all p-values >0.05). These findings suggest that LBBAP provides superior MW preservation compared to RVP, with significant benefits in GWI and GWE, while demonstrating comparable performance to HBP.http://www.sciencedirect.com/science/article/pii/S2352906725000867Left bundle branch pacingRight ventricular pacingHis bundle pacingMyocardial workCardiac pacingSystematic review |
| spellingShingle | Raffaella Mistrulli Sara Gharehdaghi Arthur Iturriagagoitia Elayne Kelen de Oliveira Lucio Addeo Stefano Valcher Sara Corradetti Michele Mattia Viscusi Peter Peytchev Ward A. Heggermont Marc Vanderheyden Emanuele Barbato Guy Van Camp Martin Penicka Myocardial work parameters in left bundle branch area pacing versus other pacing techniques: a systematic review and aggregate comparative analysis International Journal of Cardiology: Heart & Vasculature Left bundle branch pacing Right ventricular pacing His bundle pacing Myocardial work Cardiac pacing Systematic review |
| title | Myocardial work parameters in left bundle branch area pacing versus other pacing techniques: a systematic review and aggregate comparative analysis |
| title_full | Myocardial work parameters in left bundle branch area pacing versus other pacing techniques: a systematic review and aggregate comparative analysis |
| title_fullStr | Myocardial work parameters in left bundle branch area pacing versus other pacing techniques: a systematic review and aggregate comparative analysis |
| title_full_unstemmed | Myocardial work parameters in left bundle branch area pacing versus other pacing techniques: a systematic review and aggregate comparative analysis |
| title_short | Myocardial work parameters in left bundle branch area pacing versus other pacing techniques: a systematic review and aggregate comparative analysis |
| title_sort | myocardial work parameters in left bundle branch area pacing versus other pacing techniques a systematic review and aggregate comparative analysis |
| topic | Left bundle branch pacing Right ventricular pacing His bundle pacing Myocardial work Cardiac pacing Systematic review |
| url | http://www.sciencedirect.com/science/article/pii/S2352906725000867 |
| work_keys_str_mv | AT raffaellamistrulli myocardialworkparametersinleftbundlebranchareapacingversusotherpacingtechniquesasystematicreviewandaggregatecomparativeanalysis AT saragharehdaghi myocardialworkparametersinleftbundlebranchareapacingversusotherpacingtechniquesasystematicreviewandaggregatecomparativeanalysis AT arthuriturriagagoitia myocardialworkparametersinleftbundlebranchareapacingversusotherpacingtechniquesasystematicreviewandaggregatecomparativeanalysis AT elaynekelendeoliveira myocardialworkparametersinleftbundlebranchareapacingversusotherpacingtechniquesasystematicreviewandaggregatecomparativeanalysis AT lucioaddeo myocardialworkparametersinleftbundlebranchareapacingversusotherpacingtechniquesasystematicreviewandaggregatecomparativeanalysis AT stefanovalcher myocardialworkparametersinleftbundlebranchareapacingversusotherpacingtechniquesasystematicreviewandaggregatecomparativeanalysis AT saracorradetti myocardialworkparametersinleftbundlebranchareapacingversusotherpacingtechniquesasystematicreviewandaggregatecomparativeanalysis AT michelemattiaviscusi myocardialworkparametersinleftbundlebranchareapacingversusotherpacingtechniquesasystematicreviewandaggregatecomparativeanalysis AT peterpeytchev myocardialworkparametersinleftbundlebranchareapacingversusotherpacingtechniquesasystematicreviewandaggregatecomparativeanalysis AT wardaheggermont myocardialworkparametersinleftbundlebranchareapacingversusotherpacingtechniquesasystematicreviewandaggregatecomparativeanalysis AT marcvanderheyden myocardialworkparametersinleftbundlebranchareapacingversusotherpacingtechniquesasystematicreviewandaggregatecomparativeanalysis AT emanuelebarbato myocardialworkparametersinleftbundlebranchareapacingversusotherpacingtechniquesasystematicreviewandaggregatecomparativeanalysis AT guyvancamp myocardialworkparametersinleftbundlebranchareapacingversusotherpacingtechniquesasystematicreviewandaggregatecomparativeanalysis AT martinpenicka myocardialworkparametersinleftbundlebranchareapacingversusotherpacingtechniquesasystematicreviewandaggregatecomparativeanalysis |