Real-world adoption of left bundle branch area pacing: Insights from the Conduction-System pacing Italian Network Group (C-SING).
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Dell'Era Gabriele, Palmisano Pietro, Bertini Matteo, Magnano Massimo, Baroni Matteo, Volpicelli Mario, Mirizzi Gianluca, Donateo Paolo, De Mattia Luca, Perini Alessandro Paoletti, Rovaris Giovanni, Solimene Francesco, Rapacciuolo Antonio, Spera Francesco Raffaele, Poggio Luca, Catuzzo Bruna, Boggio Enrico, Marinaccio Leonardo, Bonanno Carlo, Mugnai Giacomo, Ruggiero Donatella, Sacchi Riccardo, Tordini Alessandra, Pastore Gianni, Coppolino Aldo, Tritto Massimo Vito, Campisi Giuseppe, Miracapillo Gennaro, Napoli Paola, Giacopelli Daniele, Patti Giuseppe
Аннотация
METHODS: Observational data from 28 Italian sites were analysed for consecutive LBBAP procedures, comparing outcomes based on operator experience levels.
RESULTS: From January 2022 to December 2023, 1250 patients (median age 78, 66.2 % male) underwent LBBAP attempt. Most frequent indications were atrioventricular block (40.8 %) and heart failure (25.6 %). Successful lead implantation was achieved in 1207 procedures (96.6 %), with a median fluoroscopy time of 6.2 min. Significant QRS duration reduction was observed in patients with interventricular conduction delay (144 ms to 120 ms, p < 0.001). Compared to low-experience operators (0-10 previous cases), high-experience operators (>50 cases) had significantly better outcomes, with reduced fluoroscopy time (5.9 min versus 9.0 min, p = 0.005) and an 86 % lower risk of lead implantation failure (adjusted odds ratio 0.14, p = 0.002). Periprocedural complications occurred in 6.2 % of patients, unaffected by operator experience. Follow-up data for 794 patients over a median of 93 days showed stable LBBAP pacing parameters and a 1.3 % loss of LBBAP capture.
CONCLUSIONS: LBBAP is routinely adopted for bradycardia and heart failure indication, with high success and acceptable complication rates, even when performed by less experienced operators. However, procedure outcomes improved significantly as operators gained experience with at least 50 prior cases. Electrical parameters remained stable with a low rate of LBBAP loss during short-term follow-up.