Clinical cardiology · 2025
Long-Term Effects of Left Bundle Branch Area Pacing Versus Traditional Right Ventricular Pacing on Atrial Fibrillation After Dual-Chamber Pacemaker Implantation.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Chen Jieruo, Wang Zefeng, Hang Fei, Sun Weiping, Li Haiwei, Wu Yongquan
Аннотация
BACKGROUND: Traditional right ventricular pacing (RVP) can lead to asynchronous cardiac mechanical contractions and increase the risk of atrial fibrillation (AF). This study aimed to compare the occurrence of new-onset AF and the progression of AF between novel physiological pacing-left bundle branch area pacing (LBBAP) and RVP with a long-term follow-up.
METHODS AND RESULTS: Patients with a dual-chamber permanent pacemaker initial implantation, no history of persistent AF, and an expected high proportion of ventricular pacing (VP ≥ 20%) were included in this retrospective cohort study (LBBAP, n = 122; RVP, n = 166). The pacing QRS duration (QRSd) of the LBBAP was significantly shorter than that of the RVP (113 ± 22 vs. 140 ± 27 ms, p < 0.001), while the intrinsic QRSd values from the two groups were comparable. During a mean follow-up of 21.9 ± 9.4 months, the composite outcome of postoperative new-onset AF or AF progression was higher in the RVP group than in the LBBAP group (RVP HR 2.62, 95%CI 1.21-5.67, p = 0.014). Left ventricular end-diastolic diameter (LVEDD) levels decreased in the LBBAP group at 1 year follow-up (50 ± 6 vs. baseline 48 ± 6, p = 0.002).
CONCLUSIONS: In a mean follow-up period of 2 years, compared to RVP, LBBAP patients with VP ≥ 20% had a decreased risk of occurrence and progression of AF events.
METHODS AND RESULTS: Patients with a dual-chamber permanent pacemaker initial implantation, no history of persistent AF, and an expected high proportion of ventricular pacing (VP ≥ 20%) were included in this retrospective cohort study (LBBAP, n = 122; RVP, n = 166). The pacing QRS duration (QRSd) of the LBBAP was significantly shorter than that of the RVP (113 ± 22 vs. 140 ± 27 ms, p < 0.001), while the intrinsic QRSd values from the two groups were comparable. During a mean follow-up of 21.9 ± 9.4 months, the composite outcome of postoperative new-onset AF or AF progression was higher in the RVP group than in the LBBAP group (RVP HR 2.62, 95%CI 1.21-5.67, p = 0.014). Left ventricular end-diastolic diameter (LVEDD) levels decreased in the LBBAP group at 1 year follow-up (50 ± 6 vs. baseline 48 ± 6, p = 0.002).
CONCLUSIONS: In a mean follow-up period of 2 years, compared to RVP, LBBAP patients with VP ≥ 20% had a decreased risk of occurrence and progression of AF events.