Binawaluya Cardiac Center Sam Ratulangi University.
Acta Med Indones. 2024 Apr;56(2):227-232.
Left bundle branch pacing (LBBP) has been subject to increasing interest over the last few years due to its capacity for physiological conduction and its advantages compared to His bundle pacing. His bundle pacing has certain limitations, such as a small pacing area for the His bundle, a high threshold that leads to battery depletion, a low R-wave amplitude that may result in atrial or His oversensing, and ventricular signal undersensing. In this case series, four patients (two female and two male) aged 62.2 ± 8.4 years old with symptomatic sick sinus disease and no scar tissue in the interventricular septum underwent LBBP. All LBBPs were done with standard LBBP using a lumenless SelectSecure 3830 lead (Medtronic®, Minneapolis, USA) with a fixed helix. The lead parameters showed a good R-wave amplitudes (13 ± 7.4 mV) and a low threshold (0.77 ± 0.17 V @ 0.4 ms). All patients were discharged on the next day. During follow-up period of 13.3 ± 12.9 months, all patients were well and no complications were noted. In conclusion, LBBP may be as an alternative of novel conduction pacing techniques and can be done relatively easy and safe, even with limited experience center.
左束支起搏（LBBP）近年来受到越来越多的关注，因为它具有生理性传导的能力，并且与希氏束起搏相比具有优势。希氏束起搏有一定的局限性，如希氏束起搏的起搏面积小、阈值高导致电池损耗、R 波幅度低可能导致心房或希氏束感知过度、心室信号感知不足。在本病例系列中，4 名年龄 62.2±8.4 岁的有症状的病态窦房结疾病患者，且室间隔无瘢痕组织，接受了 LBBP。所有 LBBP 均采用无内腔的 SelectSecure 3830 导线（美敦力，明尼苏达州，美国）进行标准 LBBP，导线带有固定螺旋。导线参数显示出良好的 R 波幅度（13±7.4 mV）和低阈值（0.77±0.17 V@0.4 ms）。所有患者均于次日出院。在 13.3±12.9 个月的随访期间，所有患者均状况良好，未出现并发症。总之，LBBP 可能是一种新型传导起搏技术的替代方法，即使在经验有限的中心，也可以相对容易且安全地进行。
