Evaluating electrical stability in left bundle branch area pacing for bradycardia patients at follow-up
Background: Physiologic pacing is safe and feasible, but whether electrical synchrony persists at follow-up in patients undergoing left bundle branch area pacing (LBBAP) is unknown. Objective: To determine performance of electrical synchrony in LBBAP patients at follow-up. Methods: Consecutive patie...
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Elsevier
2025-05-01
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| Series: | Heart Rhythm O2 |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666501825000765 |
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| author | Sem Briongos-Figuero, MD, PhD Álvaro Estévez Paniagua, MD, PhD Manuel Tapia Martínez, MD Silvia Jiménez Loeches, MD Ana Sánchez Hernández, MD Delia Heredero Palomo, RN Elena Sánchez López, RN Arantxa Luna Cabadas, RN Roberto Muñoz-Aguilera, MD, PhD |
| author_facet | Sem Briongos-Figuero, MD, PhD Álvaro Estévez Paniagua, MD, PhD Manuel Tapia Martínez, MD Silvia Jiménez Loeches, MD Ana Sánchez Hernández, MD Delia Heredero Palomo, RN Elena Sánchez López, RN Arantxa Luna Cabadas, RN Roberto Muñoz-Aguilera, MD, PhD |
| author_sort | Sem Briongos-Figuero, MD, PhD |
| collection | DOAJ |
| description | Background: Physiologic pacing is safe and feasible, but whether electrical synchrony persists at follow-up in patients undergoing left bundle branch area pacing (LBBAP) is unknown. Objective: To determine performance of electrical synchrony in LBBAP patients at follow-up. Methods: Consecutive patients with successful LBBAP for bradycardia pacing indication and preserved left ventricular ejection fraction were selected. At follow-up, a 12-lead electrocardiogram (ECG) was recorded along with echocardiography for myocardial work analysis. V6-R wave peak time (RWPT), V1-RWTP, and QRS duration were compared. Results: One hundred forty-nine patients were studied. After 18.2 ± 7.3 months, V6-RWTP decreased from 74.4 ± 8.9 milliseconds to 71.5 ± 10.6 milliseconds (P < .001) in LBBP captures and from 90.9 ± 7.2 to 85.7 ± 9.3 milliseconds (P = .011) in left ventricular septal pacing (LVSP) captures. V1-RWPT decreased from 120.5 ± 13.1 to 111.7 ± 11.8 milliseconds at follow-up (P < .001) in LBBP and from 118.6 ± 9.9 to 115.2 ± 12.1 milliseconds (P = .052) in LVSP. Paced QRS duration was also significantly reduced in LBBP (from 115.3 ± 13.6 to 107.6 ± 12.8 milliseconds at follow-up; P < .001). At follow-up, 29 patients lost the right bundle branch (RBB) delay pattern in lead V1, but QRS duration remained unchanged (111.3 ± 10.7 at implant vs 109.6 ± 12.5 milliseconds at follow-up; P = .413), as did V6-RWPT, in both LBBP (73.4 ± 5.9 at implant vs 73.1 ± 6.9 milliseconds at follow-up; P = .860) and LVSP captures (86.3 ± 5.6 at implant vs 85.3 ± 8.1 milliseconds at follow-up; P = .658). Mechanical synchrony in patients with and without RBB delay pattern was similar. Conclusions: In patients undergoing LBBAP for bradycardia pacing, electrical synchrony remained stable over time, suggesting that LBBAP is a reliable and durable method for physiologic pacing. |
| format | Article |
| id | doaj-art-e238c3e79a74451f9824d1e67e8a1a01 |
| institution | OA Journals |
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| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
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| series | Heart Rhythm O2 |
| spelling | doaj-art-e238c3e79a74451f9824d1e67e8a1a012025-08-20T01:55:27ZengElsevierHeart Rhythm O22666-50182025-05-016557658710.1016/j.hroo.2025.02.011Evaluating electrical stability in left bundle branch area pacing for bradycardia patients at follow-upSem Briongos-Figuero, MD, PhD0Álvaro Estévez Paniagua, MD, PhD1Manuel Tapia Martínez, MD2Silvia Jiménez Loeches, MD3Ana Sánchez Hernández, MD4Delia Heredero Palomo, RN5Elena Sánchez López, RN6Arantxa Luna Cabadas, RN7Roberto Muñoz-Aguilera, MD, PhD8Cardiology Department. Hospital Infanta Leonor Hospital. Gran Vía del Este, 28030, Madrid, Spain; Address reprint requests and correspondence: Sem Briongos-Figuero MD, PhD, Cardiology department, Infanta Leonor Hospital, Gran Vía del Este, 28030, Madrid, Spain.Cardiology Department. Hospital Infanta Leonor Hospital. Gran Vía del Este, 28030, Madrid, SpainCardiology Department. Hospital Central de la Defensa Gómez Ulla, Glorieta del Ejército, 1, 28047, Madrid, SpainCardiology Department. Hospital Infanta Leonor Hospital. Gran Vía del Este, 28030, Madrid, SpainCardiology Department. Hospital Infanta Leonor Hospital. Gran Vía del Este, 28030, Madrid, SpainCardiology Department. Hospital Infanta Leonor Hospital. Gran Vía del Este, 28030, Madrid, SpainCardiology Department. Hospital Infanta Leonor Hospital. Gran Vía del Este, 28030, Madrid, SpainCardiology Department. Hospital Infanta Leonor Hospital. Gran Vía del Este, 28030, Madrid, SpainCardiology Department. Hospital Infanta Leonor Hospital. Gran Vía del Este, 28030, Madrid, SpainBackground: Physiologic pacing is safe and feasible, but whether electrical synchrony persists at follow-up in patients undergoing left bundle branch area pacing (LBBAP) is unknown. Objective: To determine performance of electrical synchrony in LBBAP patients at follow-up. Methods: Consecutive patients with successful LBBAP for bradycardia pacing indication and preserved left ventricular ejection fraction were selected. At follow-up, a 12-lead electrocardiogram (ECG) was recorded along with echocardiography for myocardial work analysis. V6-R wave peak time (RWPT), V1-RWTP, and QRS duration were compared. Results: One hundred forty-nine patients were studied. After 18.2 ± 7.3 months, V6-RWTP decreased from 74.4 ± 8.9 milliseconds to 71.5 ± 10.6 milliseconds (P < .001) in LBBP captures and from 90.9 ± 7.2 to 85.7 ± 9.3 milliseconds (P = .011) in left ventricular septal pacing (LVSP) captures. V1-RWPT decreased from 120.5 ± 13.1 to 111.7 ± 11.8 milliseconds at follow-up (P < .001) in LBBP and from 118.6 ± 9.9 to 115.2 ± 12.1 milliseconds (P = .052) in LVSP. Paced QRS duration was also significantly reduced in LBBP (from 115.3 ± 13.6 to 107.6 ± 12.8 milliseconds at follow-up; P < .001). At follow-up, 29 patients lost the right bundle branch (RBB) delay pattern in lead V1, but QRS duration remained unchanged (111.3 ± 10.7 at implant vs 109.6 ± 12.5 milliseconds at follow-up; P = .413), as did V6-RWPT, in both LBBP (73.4 ± 5.9 at implant vs 73.1 ± 6.9 milliseconds at follow-up; P = .860) and LVSP captures (86.3 ± 5.6 at implant vs 85.3 ± 8.1 milliseconds at follow-up; P = .658). Mechanical synchrony in patients with and without RBB delay pattern was similar. Conclusions: In patients undergoing LBBAP for bradycardia pacing, electrical synchrony remained stable over time, suggesting that LBBAP is a reliable and durable method for physiologic pacing.http://www.sciencedirect.com/science/article/pii/S2666501825000765Left bundle branch area pacingElectrical synchronyRight bundle branch delay patternQRS duration |
| spellingShingle | Sem Briongos-Figuero, MD, PhD Álvaro Estévez Paniagua, MD, PhD Manuel Tapia Martínez, MD Silvia Jiménez Loeches, MD Ana Sánchez Hernández, MD Delia Heredero Palomo, RN Elena Sánchez López, RN Arantxa Luna Cabadas, RN Roberto Muñoz-Aguilera, MD, PhD Evaluating electrical stability in left bundle branch area pacing for bradycardia patients at follow-up Heart Rhythm O2 Left bundle branch area pacing Electrical synchrony Right bundle branch delay pattern QRS duration |
| title | Evaluating electrical stability in left bundle branch area pacing for bradycardia patients at follow-up |
| title_full | Evaluating electrical stability in left bundle branch area pacing for bradycardia patients at follow-up |
| title_fullStr | Evaluating electrical stability in left bundle branch area pacing for bradycardia patients at follow-up |
| title_full_unstemmed | Evaluating electrical stability in left bundle branch area pacing for bradycardia patients at follow-up |
| title_short | Evaluating electrical stability in left bundle branch area pacing for bradycardia patients at follow-up |
| title_sort | evaluating electrical stability in left bundle branch area pacing for bradycardia patients at follow up |
| topic | Left bundle branch area pacing Electrical synchrony Right bundle branch delay pattern QRS duration |
| url | http://www.sciencedirect.com/science/article/pii/S2666501825000765 |
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