Feasibility and safety of left bundle branch area pacing in cardiac amyloidosis. A single center experience
© 2023 Wiley Periodicals LLC..
BACKGROUND: Conventional right ventricle (RV) pacemaker stimulation has been associated with worse clinical outcomes in patients with cardiac amyloidosis (CA). Left bundle branch area pacing (LABPP) has been suggested as a promising alternative. We sought to assess the safety, feasibility, and outcomes of LABPP in patients with CA.
METHODS: We retrospectively analyzed echocardiography and pacing parameters and clinical outcomes in 23 consecutive patients with CA and LBBAP implanted from June 2020 to October 2022.
RESULTS: LBBAP was successfully performed in 22 over 23 patients (19 male, 78.6 ± 11.7 years, 20 ATTR, mean LVEF 45.5 ± 16.2%). After the procedure, 9 patients showed Qr pattern and 11 a qR pattern in V1 on ECG. Average procedure time was 67 ± 28 min. After 7.7 ± 5.2 months follow-up, no procedure-related complications had occurred. Although, a significant reduction in QRS width (p = .001) was achieved, we did not observe significant changes in LVEF and Nt ProBNP at 6 months of follow-up. Pacing parameters were stable during follow-up: LBB capture threshold and R wave amplitude were 1.0 ± 0.5 V and 10.6 ± 6.0 mV versus 0.8 ± 0.1 V, p = .21 and 10.6 ± 5.1 mV (p = .985) at follow up.
CONCLUSION: LBBAP is safe and feasible pacing technique for patients with CA. LBBAP is associated with significant narrowing of QRSd without worsening in LVEF and Nt-proBNP.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:47 |
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| Enthalten in: |
Pacing and clinical electrophysiology : PACE - 47(2024), 1 vom: 01. Jan., Seite 149-155 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pham-Trung, Chinh [VerfasserIn] |
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| Links: |
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| Themen: |
AL amyloidosis |
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| Anmerkungen: |
Date Completed 11.01.2024 Date Revised 19.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/pace.14894 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM365465240 |
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| 100 | 1 | |a Pham-Trung, Chinh |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Feasibility and safety of left bundle branch area pacing in cardiac amyloidosis. A single center experience |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 11.01.2024 | ||
| 500 | |a Date Revised 19.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 Wiley Periodicals LLC. | ||
| 520 | |a BACKGROUND: Conventional right ventricle (RV) pacemaker stimulation has been associated with worse clinical outcomes in patients with cardiac amyloidosis (CA). Left bundle branch area pacing (LABPP) has been suggested as a promising alternative. We sought to assess the safety, feasibility, and outcomes of LABPP in patients with CA | ||
| 520 | |a METHODS: We retrospectively analyzed echocardiography and pacing parameters and clinical outcomes in 23 consecutive patients with CA and LBBAP implanted from June 2020 to October 2022 | ||
| 520 | |a RESULTS: LBBAP was successfully performed in 22 over 23 patients (19 male, 78.6 ± 11.7 years, 20 ATTR, mean LVEF 45.5 ± 16.2%). After the procedure, 9 patients showed Qr pattern and 11 a qR pattern in V1 on ECG. Average procedure time was 67 ± 28 min. After 7.7 ± 5.2 months follow-up, no procedure-related complications had occurred. Although, a significant reduction in QRS width (p = .001) was achieved, we did not observe significant changes in LVEF and Nt ProBNP at 6 months of follow-up. Pacing parameters were stable during follow-up: LBB capture threshold and R wave amplitude were 1.0 ± 0.5 V and 10.6 ± 6.0 mV versus 0.8 ± 0.1 V, p = .21 and 10.6 ± 5.1 mV (p = .985) at follow up | ||
| 520 | |a CONCLUSION: LBBAP is safe and feasible pacing technique for patients with CA. LBBAP is associated with significant narrowing of QRSd without worsening in LVEF and Nt-proBNP | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a AL amyloidosis | |
| 650 | 4 | |a cardiac amyloidosis | |
| 650 | 4 | |a cardiac resynchronization therapy | |
| 650 | 4 | |a heart failure | |
| 650 | 4 | |a left bundle branch area pacing | |
| 650 | 4 | |a transthyretin cardiac amyloidosis | |
| 700 | 1 | |a Veloza-Urrea, Darwin |e verfasserin |4 aut | |
| 700 | 1 | |a Segura-Domínguez, Melodie |e verfasserin |4 aut | |
| 700 | 1 | |a De la Rosa Rojas, Yuleisy |e verfasserin |4 aut | |
| 700 | 1 | |a Aguilera-Agudo, Cristina |e verfasserin |4 aut | |
| 700 | 1 | |a García-Izquierdo, Eusebio Alejandro |e verfasserin |4 aut | |
| 700 | 1 | |a García-Rodríguez, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Jiménez-Sánchez, Diego |e verfasserin |4 aut | |
| 700 | 1 | |a Lorente-Ros, Alvaro |e verfasserin |4 aut | |
| 700 | 1 | |a Mingo-Santos, Susana |e verfasserin |4 aut | |
| 700 | 1 | |a Gonzalez-Lopez, Esther |e verfasserin |4 aut | |
| 700 | 1 | |a Domínguez, Fernando |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia-Pavia, Pablo |e verfasserin |4 aut | |
| 700 | 1 | |a Toquero-Ramos, Jorge |e verfasserin |4 aut | |
| 700 | 1 | |a Fernández-Lozano, Ignacio |e verfasserin |4 aut | |
| 700 | 1 | |a Castro-Urda, Víctor |e verfasserin |4 aut | |
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