Xi Wang, Yuanning Xu, Lijun Zeng, Kun Tan, Xueli Zhang, Xu Han, Tianyuan Xiong, Zhengang Zhao, Yong Peng, Jiafu Wei, Qiao Li, Sen He, Yong Chen, Minggang Zhou, Xi Li, Xin Wei, Yujia Liang, Wenxia Zhou, Lingyun Jiang, Xingbin Liu, Wei Meng, Rui Zhou, Guojun Xiong, Min Dai, Xiaojian Deng, Yuan Feng, Mao Chen
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Long-term outcomes, including all-cause death, heart failure rehospitalization (HFH), and left ventricular ejection fraction (LVEF) change compared to baseline, were obtained until 5 years post-TAVI.</p><p><strong>Results: </strong>The mean age of the overall population was 74 years, with a mean surgical risk score of 4.4%. The paced QRS duration was significantly longer in the RVP group compared with the LBBAP group (151 ± 18 vs 122 ± 12 ms; P < .001). No difference was found between the 2 groups in all-cause death (13.7% vs 13.3%; adjusted hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.37-1.58; P = .466) or the composite endpoint of death and HFH (29.9% vs 19.2%; adjusted HR, 1.22; 95% CI, 0.70-2.13; P = .476); however, the risk of HFH was significantly higher in the RVP group at 5 years after TAVI (21.4% vs 7.5%; adjusted HR, 2.26; 95% CI, 1.01-5.08; P = .048). There was greater improvement of LVEF over time in the LBBAP group (P = .046 for LVEF changes over time between groups).</p><p><strong>Conclusions: </strong>LBBAP improved long-term clinical outcomes compared with RVP in patients undergoing PPMI after TAVI in terms of less HFH and better LVEF improvement.</p>","PeriodicalId":5,"journal":{"name":"ACS Applied Materials & Interfaces","volume":null,"pages":null},"PeriodicalIF":8.3000,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-term outcomes of left bundle branch area pacing compared with right ventricular pacing in TAVI patients.\",\"authors\":\"Xi Wang, Yuanning Xu, Lijun Zeng, Kun Tan, Xueli Zhang, Xu Han, Tianyuan Xiong, Zhengang Zhao, Yong Peng, Jiafu Wei, Qiao Li, Sen He, Yong Chen, Minggang Zhou, Xi Li, Xin Wei, Yujia Liang, Wenxia Zhou, Lingyun Jiang, Xingbin Liu, Wei Meng, Rui Zhou, Guojun Xiong, Min Dai, Xiaojian Deng, Yuan Feng, Mao Chen\",\"doi\":\"10.1016/j.hrthm.2024.09.021\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>New-onset permanent pacemaker implantation (PPMI) is still a common complication after transcatheter aortic valve implantation (TAVI) with adverse clinical outcomes.</p><p><strong>Objective: </strong>The purpose of this study was to investigate whether left bundle branch area pacing (LBBAP) improves long-term clinical results compared with traditional right ventricular pacing (RVP) in patients requiring PPMI after TAVI.</p><p><strong>Methods: </strong>A total of 237 consecutive patients undergoing RVP (N = 117) or LBBAP (N = 120) after TAVI were retrospectively included. 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引用次数: 0
摘要
背景：新发永久性起搏器植入术（PPMI）仍是经导管主动脉瓣植入术（TAVI）后的常见并发症，会带来不良的临床结果：与传统的右室起搏（RVP）相比，左束支区起搏（LBBAP）是否能改善TAVI术后需要PPMI患者的长期临床效果：回顾性纳入了237例在TAVI术后接受RVP（117例）或LBBAP（120例）治疗的连续患者。研究结果显示，TAVI术后5年前的长期结果包括全因死亡、心衰再住院（HFH）和左室射血分数（LVEF）与基线相比的变化：所有患者的平均年龄为74岁，平均手术风险评分为4.4%。与LBBAP组相比，RVP组的起搏QRS持续时间明显更长（151 ± 18 vs. 122 ± 12 ms）：与RVP相比，LBBAP可改善TAVI术后PPMI患者的长期临床预后，减少HFH，改善LVEF。
Long-term outcomes of left bundle branch area pacing compared with right ventricular pacing in TAVI patients.
Background: New-onset permanent pacemaker implantation (PPMI) is still a common complication after transcatheter aortic valve implantation (TAVI) with adverse clinical outcomes.
Objective: The purpose of this study was to investigate whether left bundle branch area pacing (LBBAP) improves long-term clinical results compared with traditional right ventricular pacing (RVP) in patients requiring PPMI after TAVI.
Methods: A total of 237 consecutive patients undergoing RVP (N = 117) or LBBAP (N = 120) after TAVI were retrospectively included. Long-term outcomes, including all-cause death, heart failure rehospitalization (HFH), and left ventricular ejection fraction (LVEF) change compared to baseline, were obtained until 5 years post-TAVI.
Results: The mean age of the overall population was 74 years, with a mean surgical risk score of 4.4%. The paced QRS duration was significantly longer in the RVP group compared with the LBBAP group (151 ± 18 vs 122 ± 12 ms; P < .001). No difference was found between the 2 groups in all-cause death (13.7% vs 13.3%; adjusted hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.37-1.58; P = .466) or the composite endpoint of death and HFH (29.9% vs 19.2%; adjusted HR, 1.22; 95% CI, 0.70-2.13; P = .476); however, the risk of HFH was significantly higher in the RVP group at 5 years after TAVI (21.4% vs 7.5%; adjusted HR, 2.26; 95% CI, 1.01-5.08; P = .048). There was greater improvement of LVEF over time in the LBBAP group (P = .046 for LVEF changes over time between groups).
Conclusions: LBBAP improved long-term clinical outcomes compared with RVP in patients undergoing PPMI after TAVI in terms of less HFH and better LVEF improvement.
期刊介绍：
ACS Applied Materials & Interfaces is a leading interdisciplinary journal that brings together chemists, engineers, physicists, and biologists to explore the development and utilization of newly-discovered materials and interfacial processes for specific applications. Our journal has experienced remarkable growth since its establishment in 2009, both in terms of the number of articles published and the impact of the research showcased. We are proud to foster a truly global community, with the majority of published articles originating from outside the United States, reflecting the rapid growth of applied research worldwide.
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