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IF 2.4 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2025-03-18 DOI:10.1002/clc.70116

Jieruo Chen, Zefeng Wang, Fei Hang, Weiping Sun, Haiwei Li, Yongquan Wu

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引用次数: 0

摘要

背景传统的右心室起搏（RVP）会导致心脏机械性收缩不同步，增加心房颤动（AF）的风险。本研究旨在通过长期随访，比较新型生理起搏-左束支区起搏（LBBAP）和 RVP 的新发房颤发生率和房颤进展情况。方法和结果该回顾性队列研究纳入了初次植入双腔永久起搏器、无持续性房颤病史、预计室性起搏比例较高（VP ≥ 20%）的患者（LBBAP，n = 122；RVP，n = 166）。LBBAP 的起搏 QRS 持续时间（QRSd）明显短于 RVP（113 ± 22 vs. 140 ± 27 ms，p < 0.001），而两组的内在 QRSd 值相当。在平均 21.9 ± 9.4 个月的随访期间，RVP 组术后新发房颤或房颤进展的综合结果高于 LBBAP 组（RVP HR 2.62，95%CI 1.21-5.67，p = 0.014）。随访一年时，LBBAP 组的左心室舒张末期直径 (LVEDD) 水平有所下降（50 ± 6 vs. 基线 48 ± 6，p = 0.002）。结论在平均 2 年的随访期间，与 RVP 相比，VP ≥ 20% 的 LBBAP 患者发生房颤事件和房颤事件进展的风险更低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Long-Term Effects of Left Bundle Branch Area Pacing Versus Traditional Right Ventricular Pacing on Atrial Fibrillation After Dual-Chamber Pacemaker Implantation

查看原文本刊更多论文

Long-Term Effects of Left Bundle Branch Area Pacing Versus Traditional Right Ventricular Pacing on Atrial Fibrillation After Dual-Chamber Pacemaker Implantation

Background

Traditional right ventricular pacing (RVP) can lead to asynchronous cardiac mechanical contractions and increase the risk of atrial fibrillation (AF). This study aimed to compare the occurrence of new-onset AF and the progression of AF between novel physiological pacing—left bundle branch area pacing (LBBAP) and RVP with a long-term follow-up.

Methods and Results

Patients with a dual-chamber permanent pacemaker initial implantation, no history of persistent AF, and an expected high proportion of ventricular pacing (VP ≥ 20%) were included in this retrospective cohort study (LBBAP, n = 122; RVP, n = 166). The pacing QRS duration (QRSd) of the LBBAP was significantly shorter than that of the RVP (113 ± 22 vs. 140 ± 27 ms, p < 0.001), while the intrinsic QRSd values from the two groups were comparable. During a mean follow-up of 21.9 ± 9.4 months, the composite outcome of postoperative new-onset AF or AF progression was higher in the RVP group than in the LBBAP group (RVP HR 2.62, 95%CI 1.21–5.67, p = 0.014). Left ventricular end-diastolic diameter (LVEDD) levels decreased in the LBBAP group at 1 year follow-up (50 ± 6 vs. baseline 48 ± 6, p = 0.002).

Conclusions

In a mean follow-up period of 2 years, compared to RVP, LBBAP patients with VP ≥ 20% had a decreased risk of occurrence and progression of AF events.

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.