Comparison of left bundle branch area pacing between patients with pacing-induced cardiomyopathy and non-ischemic dilated cardiomyopathy

IF 3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology Pub Date : 2024-10-30 DOI:10.1016/j.cpcardiol.2024.102886

Jorge Perea-Armijo MD , Guillermo Gutiérrez-Ballesteros MD , Francisco Mazuelos-Bellido MD, PhD , Rafael González-Manzanares MD, PhD , Jose María Huelva BsC , Jose López-Aguilera MD, PhD , Manuel Pan MD, PhD , José María Segura Saint-Gerons MD, PhD

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引用次数: 0

Abstract

Introduction

Left bundle branch area pacing (LBBAP) seems to be an alternative to coronary sinus pacing in patients with non-ischaemic dilated cardiomyopathy (NI-DCM) with left bundle branch block (LBBB) and in pacing-induced cardiomyopathy (PICM). The aim of the study was to compare the response of LBBAP in severe forms of both entities.

Material and methods

Prospective study of patients with severe forms of PICM and NI-DCM in NYHA II-IV who underwent LBBAP. Clinical, electrocardiographic, echocardiographic and electrical parameters were analysed and the medium-term prognostic impact was assessed.

Results

Eighty patients were included, 25 with PICM and 55 with NI-DCM. PICM patients were older (PICM 75 [IQR 71-83.5] y.o vs NI-DCM 72 [IQR 60-78.5] y.o;p=0.01) and with longer baseline QRS duration (PICM 180 [IQR 167-194] ms vs NI-DCM 168 [IQR 153-178] ms;p<0.01), with no differences in left ventricular ejection fraction (LVEF) or medical treatment. QRS reduction occurred in both groups, being greater in PICM (PICM CI 95% 54±20 ms, p<0.01; NI-DCM CI 95% 40±15 ms;p<0.01). A NT-ProBNP levels reduction and LVEF improvement were observed without differences between groups. At follow-up, there were no differences in admissions for HF (PICM 4.2% vs NI-DCM 11%;p=0.413), cardiac mortality (PICM 14.9% vs NI-DCM 2.9%;p=0.13) and all-cause mortality (PICM 21.7% vs NI-DCM 10.9%;p=0.08).

Conclusion

LBBAP is an effective technique with a NT-ProBNP levels reduction and LVEF improvement in both groups without differences. At follow-up, both groups had a low rate of HF readmissions and there was a non-significant trend toward higher total mortality in PICM.

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起搏诱发型心肌病和非缺血性扩张型心肌病患者左束支区起搏的比较。

导言：对于伴有左束支传导阻滞（LBBB）的非缺血性扩张型心肌病（NI-DCM）患者和起搏诱发型心肌病（PICM）患者而言，左束支区域起搏（LBBAP）似乎是冠状窦起搏的替代方案。研究的目的是比较 LBBAP 对这两种病症的严重类型的反应：对接受 LBBAP 的 NYHA II-IV 级重度 PICM 和 NI-DCM 患者进行前瞻性研究。分析了临床、心电图、超声心动图和心电参数，并评估了中期预后影响：共纳入 80 例患者，其中 25 例为 PICM 患者，55 例为 NI-DCM 患者。PICM 患者年龄较大（PICM 75 [IQR 71-83.5] y.o vs NI-DCM 72 [IQR 60-78.5] y.o; p=0.01），基线 QRS 持续时间较长（PICM 180 [IQR 167-194] ms vs NI-DCM 168 [IQR 153-178] ms; p结论：LBBAP 是一种有效的技术，两组患者的 NT-ProBNP 水平均有所下降，LVEF 均有所改善，且无差异。在随访中，两组患者的 HF 再入院率都很低，而 PICM 的总死亡率有上升趋势，但不明显。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Problems in Cardiology 医学-心血管系统

CiteScore

4.80

自引率

2.40%

发文量

392

审稿时长

6 days

期刊介绍： Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.