Left bundle branch pacing did not significantly decrease mean QRS duration at 4 years in patients with pre-existing LBBB (136.36 ms vs 148.60 ms at baseline; p=0.25).
Cohort (n=271)
No
Does left bundle branch pacing maintain long-term efficacy and safety in patients requiring pacing?
Left bundle branch pacing is a reliable physiologic pacing technique with stable long-term capture thresholds and minimal complications over 4 years.
Absolute Event Rate: 136.36% vs 148.6%
p-value: p=0.25
Abstract Background Left bundle branch pacing (LBBP) has emerged as a pivotal tool in the current era of pacing. Long term efficacy and safety data is still lacking. Purpose This study aims to analyze long term efficacy and safety of LBBP. Methods We collected data for patients who underwent LBBP between January 2019 and November 2023. All patients who had pre-implantation ECG and adequate follow-up ECG, device interrogation and echocardiograms were included. Baseline characteristics, electrophysiologic data, echocardiographic data, and complication data were analyzed with regression analysis and paired t-test. Results A total of 271 patients who had adequate follow-up data were included. Mean age was 76 years, 39% were females. 35 patients had baseline left bundle branch block (LBBB). All patients underwent selective LBB capture. Average procedure time was 75 minutes with 10 minutes of average fluoroscopy time. Mean QRS for patients with pre-existing LBBB did decrease, but not significantly, upon LBBP implantation (144.20 ± 26.22 ms versus 138.81 ± 23.83 ms, p = 0.35), at 2 years (144.20 ± 26.22 ms versus 136.84 ± 23.33, p = 0.27), at 3 years (144.20 ± 26.22 ms versus 137.47 ± 20.56 ms, p = 0.29), or at 4 years (148.60 ± 25.01 versus 136.36 ± 24.48, p = 0.25). Mean LVEF for patients with pre-implantation LBBB was not statistically significantly different at 2 years post-implantation or further follow-up. Only 2 patients had capture threshold 2 V at 0.4 ms at 4 years, one of whom had lost selective LBB capture. No lead revision was required. 20 patients (18%) had persistent right bundle branch block pattern 4 years post-implantation. Conclusion Left bundle branch pacing is a reliable and successful physiologic pacing technique with minimal complications long-term. Although mean QRS duration did not have a statitstically significant decrease post LBBP, despite showing a reducing trend, mean LVEF did not change either.Difference in QRS pre- and post- LBBPDifference in LVEF pre- and post- LBBP
Mahajan et al. (Mon,) conducted a cohort in Patients requiring pacing (n=271). Left bundle branch pacing (LBBP) vs. Baseline (pre-implantation) was evaluated on Mean QRS duration at 4 years in patients with pre-existing LBBB (p=0.25). Left bundle branch pacing did not significantly decrease mean QRS duration at 4 years in patients with pre-existing LBBB (136.36 ms vs 148.60 ms at baseline; p=0.25).
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