Left bundle branch area pacing in patients with severe interventricular septal hypertrophy: A multicenter study assessing feasibility, safety, and outcomes of lumenless and stylet-driven leads

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart Rhythm O2 Pub Date : 2025-05-01 DOI:10.1016/j.hroo.2025.02.018

Sanjai Pattu Valappil MD, DM , Abhinav B. Anand MD, DM , Anindya Ghosh MD, DM , Krishnaswamy Subramanyan MD, DM , Pramod Jaiswal MD, DM , Krishnan Jayanthi MD, DNB , Golla N. Prasad MD, DNB , Tirupattur S. Srinath MD, DNB , Shilpa Menon MD, DM , Sharan Shreedhar MD , Karthikeyan D DMRD, DNB, Radiology , Velayudhan Bashi MS, MCH , Justin Paul MD, DNB, DM , Elangovan Elavarasi Manimegalai MD, DM , Immanuel Sathiakumar Arunkumar MD (General Medicine), DM (Cardiology) , Sriram Veeraraghavan MD, DM , Saran G. Kumar BSc , Soli Rajaram Ramkumar MD, DM , Raniya Palliyedath MBBS , Shaima Hafeez MBBS , Ulhas M. Pandurangi MD, DM

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引用次数: 0

Abstract

Background

There has been limited success using left bundle branch area pacing (LBBAP) in patients with severe interventricular septal hypertrophy (IVSH).

Objective

This study assesses the feasibility, safety, and outcome of LBBAP in patients with severe IVSH.

Methods

19 adult patients with severe IVSH who underwent LBBAP were enrolled. Baseline patient characteristics, procedural data, and postprocedural results were collected. The feasibility of LBBAP in patients with severe IVSH using the lumenless leads (LLL) and stylet-driven leads (SDL) were analyzed.

Results

19 IVSH and 529 normal septal thickness (NST) patients underwent LBBAP. Implant success was achieved in 497 patients with NST (93.9%) and 14 patients with severe IVSH (73.6%). Among the 19 patients with severe IVSH, 7 patients underwent attempted LBBAP using LLL, with successful outcomes in 4 (57.1%). The remaining 12 patients underwent LBBAP with SDL, of which 10 were successful (83.3%). Mean septal thickness (20 ± 1.9 vs 21 ± 2.2), paced QRS duration (123 ± 17 vs 121 ± 9), and left ventricular activation time (LVAT) (75 ± 6 vs 74 ± 9) were comparable in the LLL and SDL groups. The lead thresholds (0.8 ± 0.3) remained stable over the mean follow-up duration of 36 ± 28.67 months without any lead-related complications.

Conclusion

LBBAP in patients with severe IVSH is safe and feasible. Although the overall success rates in this subgroup were lower (73.6%) compared with patients with NST, this was not significantly different with the use of SDL (83.3%) (P = .15).

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重度室间隔肥厚患者左束支区起搏：一项多中心研究，评估无腔导联和样式驱动导联的可行性、安全性和结果

背景：在严重室间隔肥厚（IVSH）患者中使用左束分支区域起搏（LBBAP）的成功率有限。目的评价LBBAP治疗重度IVSH患者的可行性、安全性和预后。方法选取19例行LBBAP治疗的成人重症IVSH患者。收集患者的基线特征、手术数据和术后结果。分析了采用无腔导联（LLL）和样式驱动导联（SDL）对重度IVSH患者进行LBBAP的可行性。结果19例IVSH患者和529例鼻中隔厚度正常（NST）患者行LBBAP。497例NST患者（93.9%）和14例重度IVSH患者（73.6%）种植成功。在19例重度IVSH患者中，7例患者尝试使用LLL进行LBBAP， 4例成功（57.1%）。其余12例患者行LBBAP伴SDL，其中10例成功（83.3%）。LLL组和SDL组的平均间隔厚度（20±1.9 vs 21±2.2）、QRS节律持续时间（123±17 vs 121±9）和左心室激活时间（LVAT）（75±6 vs 74±9）具有可比性。在36±28.67个月的平均随访期间，铅阈值（0.8±0.3）保持稳定，无铅相关并发症。结论lbbap治疗重症IVSH是安全可行的。尽管与NST患者相比，该亚组的总体成功率较低（73.6%），但与使用SDL的患者（83.3%）没有显著差异（P = 0.15）。

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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