Chen Xueying, Wei Lanfang, Bai Jin, Wang Wei, Qin Shengmei, Wang Jingfeng, Liang Yixiu, Su Yangang, Ge Junbo
Department of Cardiology, Zhongshan Hospital of Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, China.
Department of Cardiology, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China.
Front Cardiovasc Med. 2021 Mar 24;8:645947. doi: 10.3389/fcvm.2021.645947. eCollection 2021.
Although left bundle branch pacing (LBBP) has emerged as a novel physiological pacing strategy with a low and stable threshold, its safety has not been well-documented. In the present study, we included all the patients with procedure-related complications at our centre to estimate these LBBP cases with unique complications. We enrolled 612 consecutive patients who received the procedure in Zhongshan Hospital, Fudan University, between January 2018 and July 2020. Regular follow-ups were conducted (at 1, 3, and 6 months in the first year and every 6-12 months from the second year), and the clinical data of the patients with complications were collected and analyzed. With a mean follow-up period of 12.32 ± 5.21 months, procedure-related complications were observed in 10 patients (1.63%) that included two postoperative septum perforations (2/612, 0.33%), two postoperative lead dislodgements (2/612, 0.33%), four intraoperative septum injuries (4/612, 0.65%), and two intraoperative lead fractures (2/612, 0.33%). Pacing parameters were stable during follow-up, and no major complications were observed after lead repositioning in the cases of septum perforation and lead dislodgement. The incidence of procedure-related complications for LBBP, namely postoperative septum perforation, postoperative lead dislodgement, intraoperative septum injury, and intraoperative lead fracture, were low. No adverse clinical outcomes were demonstrated after successful repositioning of the lead and appropriate treatment.
尽管左束支起搏（LBBP）已成为一种具有低且稳定阈值的新型生理性起搏策略，但其安全性尚未得到充分记录。在本研究中，我们纳入了本中心所有发生与手术相关并发症的患者，以评估这些具有独特并发症的LBBP病例。我们纳入了2018年1月至2020年7月在复旦大学附属中山医院连续接受该手术的612例患者。进行了定期随访（第一年在1、3和6个月时，第二年起每6 - 12个月），并收集和分析了有并发症患者的临床数据。平均随访期为12.32±5.21个月，10例患者（1.63%）出现了与手术相关的并发症，包括2例术后室间隔穿孔（2/612，0.33%）、2例术后导线脱位（2/612，0.33%）、4例术中室间隔损伤（4/612，0.65%）和2例术中导线断裂（2/612，0.33%）。随访期间起搏参数稳定，在室间隔穿孔和导线脱位病例中，导线重新定位后未观察到重大并发症。LBBP与手术相关并发症的发生率，即术后室间隔穿孔、术后导线脱位、术中室间隔损伤和术中导线断裂，较低。导线成功重新定位并进行适当治疗后，未出现不良临床结局。
