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Left bundle branch area pacing- follow up data on pacing performance
Session:
Comunicações Orais - Sessão 08 - Dispositivos em Arritmologia
Speaker:
Joana Certo Pereira
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:
Joana Certo Pereira; Daniel A. Gomes; Francisco Moscoso Costa; Rita Reis Santos; Gustavo Rodrigues; Daniel Matos; João Carmo; Gabriela Bem; Sandra Feliciano; Isabel Santos; Pedro Galvão Santos; Pedro Carmo; Diogo Cavaco; Francisco Belo Morgado; Pedro Adragão
Abstract
<p style="text-align:justify"><span style="font-size:14px"><strong><span style="font-family:Calibri,sans-serif">Background:</span></strong></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Calibri,sans-serif">Left bundle branch area pacing (LBBAP) is an increasingly recognized modality for physiologic ventricular pacing preserving left ventricular synchrony. While data on procedural characteristics are increasingly reported, those regarding mid-long-term lead stability are not yet fully understood. We aimed to describe the procedural characteristics and stability of parameters during follow-up of a group of consecutive patients submitted to LBBAP. </span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:14px"><strong><span style="font-family:Calibri,sans-serif">Methods:</span></strong></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Calibri,sans-serif">Retrospective study of consecutive patients submitted LBBAP since November 2021 at a single center. Procedural characteristics, lead parameters and final QRS complex duration were collected immediately after implantation and during follow-up. LBBA pacing aimed to achieve right bundle branch block pattern in V1during pacing and left ventricular activation time (LVAT) < 90ms.</span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:14px"><strong><span style="font-family:Calibri,sans-serif">Results:</span></strong></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Calibri,sans-serif">Overall, 53 consecutive patients were included (mean age was 76±13 years and 62% male sex). Procedural duration was 65min (IQR 52-83) and fluoroscopy time was 4min (IQR 3-6). Median LVAT was 86ms (IQR 80-93) and QRS immediately after implantation was 112ms (IQR 105-126). Acute R-wave amplitude and pacing threshold were 7,3mV (IQR 4,1-15,3) and 0,6mV (IQR 0,50-0,73), respectively. One case of in-hospital ischemic stroke associated with withholding anticoagulation in a patient with atrial fibrillation. No other major complications, including electrode dislocation were reported at discharge. After a median follow-up of 4 (IQR 2-8) months, pacing threshold remained stable at 0,6mV (IQR 0,5-0,72) and R-wave amplitude increased to a median of 14,9mV (IQR 10,2-20,0) and QRS complex duration remained narrow at follow-up (113ms [IQR 95-132]). </span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:14px"><strong><span style="font-family:Calibri,sans-serif">Conclusion:</span></strong></span></p> <p style="text-align:justify"><span style="font-size:14px"><span style="font-family:Calibri,sans-serif">In this cohort, LBBAP was feasible and with exceptional pacing parameters that remained stable during follow up. Most relevant, QRS duration, a surrogate for ventricular synchrony, remained short, further supporting the role of this technique for the near future.</span></span></p> <p style="text-align:justify"> </p>
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