Mao Yu, Xie Yuan, Tang Jiani, Shen Yujing, Liu Yang, Sun Bing
Department of Cardiology, Tongji Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Department of Echocardiography, Tongji Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Int J Gen Med. 2023 Sep 4;16:4007-4016. doi: 10.2147/IJGM.S418315. eCollection 2023.
The purpose of this study was to assess the left ventricular function effects of permanent left bundle branch pacing (LBBP) versus traditional right ventricular pacing (RVP).
Consecutive patients receiving pacemaker implantation were included and divided into left bundle branch block (LBBB) group and right ventricular pacing (RVP) group. Baseline characteristics were collected, and they received 1-year follow-up. Electrocardiogram (ECG) characteristics and pacing parameters were assessed before and after implantation. Cardiac function parameters such as left ventricular ejection fraction (LVEF) and tricuspid regurgitation (TR) were recorded and compared.
Of 78 patients included, 45 patients received LBBP (mean age, 72.7 ± 12.2 years; male, 55.6%) and 33 patients underwent RVP (mean age 72.9 ± 11.8 years; male, 63.6%). The pacing parameters were satisfactory during the implantation and remained stable during mid-term follow-up. During the follow-up period, LBBP patients had a greater decrease in LVEDD and LVESD. The TR in the LBBP group was significantly improved as compared to the RVP group (=0.016).
Permanent LBBP achieves favorable cardiac hemodynamic effects with good stability and safety. LBBP may reduce severe TR at 1-year follow-up, and LBBP may be an option for patients with severe TR.
本研究旨在评估永久性左束支起搏(LBBP)与传统右心室起搏(RVP)对左心室功能的影响。
纳入连续接受起搏器植入的患者,并分为左束支传导阻滞(LBBB)组和右心室起搏(RVP)组。收集基线特征,并对其进行1年随访。评估植入前后的心电图(ECG)特征和起搏参数。记录并比较左心室射血分数(LVEF)和三尖瓣反流(TR)等心脏功能参数。
在纳入的78例患者中,45例接受LBBP(平均年龄72.7±12.2岁;男性占55.6%),33例接受RVP(平均年龄72.9±11.8岁;男性占63.6%)。植入过程中起搏参数满意,中期随访期间保持稳定。随访期间,LBBP患者的左心室舒张末期内径(LVEDD)和左心室收缩末期内径(LVESD)下降幅度更大。与RVP组相比,LBBP组的TR明显改善(P=0.016)。
永久性LBBP可实现良好的心脏血流动力学效果,具有良好的稳定性和安全性。LBBP在1年随访时可能减轻严重TR,对于严重TR患者,LBBP可能是一种选择。