Key result
Upgrading from leadless pacing to transvenous LBBAP linked to improved cardiac function at one month.
Why the study?
Progression of atrioventricular block and pacing-induced cardiomyopathy after leadless pacemaker implantation required evaluation of upgrade strategies.
Case Report (n=1)
Upgrading from a leadless pacemaker to a transvenous pacemaker with left bundle branch area pacing is a feasible and effective strategy for treating pacing-induced cardiomyopathy.
Should not yet change practice for pacing-induced cardiomyopathy; leaves open need for prospective validation of LBBAP upgrade.
An 80-years-old patient with permanent atrial fibrillation and symptomatic, paroxysmal atrioventricular blocks (AVBs) underwent leadless pacemaker (L-PM) implantation. Seven years after implantation, as a consequence of a progression of the AVB towards a persistent form, resulting in an increased need for pacing, he developed a pacing-induced cardiomyopathy. He then underwent a successful upgrade from L-PM to a transvenous pacemaker (T-PM) with left bundle branch area pacing (LBBAP). The L-PM did not interfere with the T-PM and was turned off and abandoned. One month after the upgrading the patient showed a significant improvement in cardiac function and functional capacity.
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Palmisano et al. (2024) conducted a case report in Pacing-induced cardiomyopathy (n=1). Upgrade to transvenous pacemaker with left bundle branch area pacing (LBBAP) was evaluated on Cardiac function and functional capacity. Upgrading from a leadless pacemaker to a transvenous pacemaker with left bundle branch area pacing resulted in significant improvement in cardiac function and functional capacity at one month.
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