Left bundle branch area pacing in 32 pediatric patients was feasible, resulting in a mean paced QRS duration of 111.7 ms and 3 cases of septal perforation resolved by lead reposition.
Observational (n=32)
No
Does left bundle branch area pacing provide stable electrical parameters and safety in pediatric patients with congenital heart disease and pacemaker-induced cardiomyopathy?
LBBAP is a feasible pacing strategy that achieves narrow paced QRS durations in pediatric patients with complex congenital heart disease and pacing-induced cardiomyopathy.
Abstract Introduction Conduction system pacing (CSP) - novel pacing option which rapidly develops during the last years and nowadays it used as a first-line approach in adults. Pediatric CSP cases may be challenging due to small chamber sizes and lack of suitable tools. Another important question is complex anatomy after correction of congenital heart diseases. We present data of single-center experience of LBBAP in complex pediatric cases after surgical correction of CHD and pacing-induced cardiomyopathy Methods Patients under 18 years old with symptomatic bradycardia and previous CHD surgery and PICM. We collected baseline data, pre-procedural electrocardiography (ECG) and transthoracic echocardiography (TTE), pacing parameters and procedural outcomes. Results Total 32 patients underwent implantation of LBBAP pacemaker. 14 (42%) patients had previous surgery for CHD and 6 patients with PICM. Mean age years 11,5±4,6 years. Weight 42,8±20,7kg. Previous medical history: Ebstein anomaly correction-1 patient(11%), VSD plasty-6 patients(66%), AV septal defect-3(33%), valvular surgery-3 patients(33%), congenitaly corrected TGA-1 patient(11%). Procedural outcomes: peak left ventricular activation time-73,4±3,9ms, V6-V1 interpeak-44,4±9,8 ms, transition from non-selective to selective capture were recorded during the implantation. Paced QRS duration-111,7±12,6 ms. Mean procedure duration 107,2±39,6 min. Fluoroscopy time-26,7±20 min. In 3 patients we observed septal perforation, which was resolved by reposition of the lead. Conclusion LBBAP in pediatric patients appears as feasible and safe procedure with stable electrical parameters, resulting in narrow paced QRS duration. Difficult anatomy after CHD correction may impact to procedure failure or lack of conduction system capture criteria. Due to small cohort of patients, further collaborative large studies are needed to evaluate long-term outcomes.Pediatric
Turubayev et al. (Mon,) conducted a observational in Congenital heart disease and pacemaker-induced cardiomyopathy (n=32). Left bundle branch area pacing (LBBAP) was evaluated on Procedural outcomes including paced QRS duration and complications. Left bundle branch area pacing in 32 pediatric patients was feasible, resulting in a mean paced QRS duration of 111.7 ms and 3 cases of septal perforation resolved by lead reposition.