Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Left bundle branch area pacing for electrical synchronization: description of a single-center experience and comparison to conventional biventricular pacing
Session:
Comunicações Orais - Sessão 08 - Dispositivos em Arritmologia
Speaker:
Daniel A. Gomes
Congress:
CPC 2023
Topic:
C. Arrhythmias and Device Therapy
Theme:
09. Device Therapy
Subtheme:
09.6 Device Therapy - Other
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Daniel A. Gomes; Francisco Moscoso Costa; Rita Reis Santos; Mariana Sousa Paiva; Gustavo Rodrigues; Daniel Matos; João Carmo; Gabriela Bem; Isabel Santos; Pedro Galvão Santos; Mafalda de Sousa; Pedro Carmo; Diogo Cavaco; Francisco Belo Morgado; Pedro Adragão
Abstract
<p><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:12pt"><strong><span style="font-size:11.0pt">Background:</span></strong></span></span></p> <p><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:12pt"><span style="font-size:11.0pt">Long-term right ventricular (RV) pacing has been shown to induce desynchrony and left ventricular (LV) dysfunction. Accordingly, some patients may need upgrade for resynchronization therapy (CRT). Left bundle branch area pacing (LBBAP) is increasingly recognized as an attractive alternative for conventional pacing, by preserving LV synchrony. We aimed to describe procedural characteristics of patients with LBBAP, and to compare final QRS duration with those undergoing biventricular CRT (BiV-CRT) for RV apical pacing induced cardiomyopathy. </span></span></span></p> <p> </p> <p><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:12pt"><strong><span style="font-size:11.0pt">Methods:</span></strong></span></span></p> <p><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:12pt"><span style="font-size:11.0pt">Single-center cohort including consecutive patients undergoing LBBAP since November 2021. Pacing lead was implanted deep on the interventricular septum, aiming to a right bundle branch pacing pattern and LV activation time (LVAT) < 90ms. Feasibility, procedure, and fluoroscopy times, electrical synchrony assessed by QRS duration immediately after implantation, and periprocedural complications were assessed. Procedure characteristics were compared to a group of consecutive patients undergoing BiV-CRT upgrade.</span></span></span></p> <p> </p> <p><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:12pt"><strong><span style="font-size:11.0pt">Results:</span></strong></span></span></p> <p><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:12pt"><span style="font-size:11.0pt">A total of 54 patients underwent LBBAP (aged 76±13 years, 63% male, 10 (19%) with LV ejection fraction [LVEF] < 50%). The most common indication was high-degree atrioventricular block (n = 27, 50%), and in 7 cases (13%) LBBAP was implanted due to failed BiV-CRT. Overall, LBBAP resulted in a median LVAT was 86ms (IQR 80-95) and in a final QRS immediately after implantation of 112ms (IQR 105-125). QRS duration was similar across LVEF categories and pacing indication (110ms [IQR 102-132] in LBBAP due to failed BiV-CRT). No cases of lead dislocation or perforation at discharge. When compared to a group of patients undergoing BiV-CRT upgrade (n = 46), LBBAP QRS complex was significantly narrower than pacing QRS before (172ms [IQR 154-184]; p<0.001) and after the upgrade (125ms [IQR 114-138]; p=0.002). Furthermore, procedure (64min [IQR 53-82] vs. 112min [IQR 94-140], p<0.001) and fluoroscopy times (4.1min [IQR 3.4-6.5] vs. 19.3min [IQR 11.6-33.6], p<0.001) were lower in the LBBAP group.</span></span></span></p> <p> </p> <p><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:12pt"><strong><span style="font-size:11.0pt">Conclusion:</span></strong></span></span></p> <p><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:12pt"><span style="font-size:11.0pt">In this series of patients undergoing LBBAP, greater electrical synchronization was achieved when compared to BiV-CRT. LBBAP seems a safe and feasible alternative pacing strategy to preserve synchrony. Further studies are needed to understand its role as first-line therapy in patients with indication for ventricular pacing to prevent desynchrony-related cardiomyopathy.</span></span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site