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Feasibility, safety and mid-term parameters stabilization of left bundle branch pacing: a single center experience
Session:
SESSÃO DE POSTERS 45 - DISPOSITIVOS CARDÍACOS IMPLANTÁVEIS: COMPLICAÇÕES E SUA PREVENÇÃO
Speaker:
António Baptista Carvalho
Congress:
CPC 2025
Topic:
C. Arrhythmias and Device Therapy
Theme:
09. Device Therapy
Subtheme:
09.1 Antibradycardia Pacing
Session Type:
Cartazes
FP Number:
---
Authors:
António Baptista Carvalho; Sofia Jacinto; Inês Neves; Helder Santos; Guilherme Portugal; Ana Lousinha; Pedro Silva Cunha; Bruno Valente; Paulo Osório; Mário Oliveira
Abstract
<p>Background: Left bundle branch pacing (LBBP) has emerged as a novel physiological pacing technique to achieve synchronous ventricular activation via capture of the His-Purkinje system, with advantages over His bundle pacing regarding superior implant parameters and stability.</p> <p>Objective: This study aims to evaluate the feasibility and mid-term follow-up data with LBBP, focusing on feasibility, safety, and the stabilization of pacing parameters over time.</p> <p>Methods: This retrospective study analyzed procedural and pacing data from patients undergoing left bundle branch pacing (2020–2023). Safety and stability of pacing parameters were assessed, with statistical analysis performed using SPSS v.27.</p> <p>From 2020 to 2023, 62 LBBP procedures were performed, predominantly in male patients (77%) with a median age of 79 (74-83) years . The main pacing indications were atrioventricular node disease (37%) and sinus node disease (63%). The median procedural duration was 100 (60-210) minutes, with a median fluoroscopy time of 10 (5-15) minutes. There were no complications during the LBBP procedures. Post-procedure, the median left ventricle activation time (LVAT) was 73 (62-84) ms, with a statistically significant reduction in QRS width (from 139±32 ms to 129±21 ms, p < 0.01, 95% CI 5.7-23.5). After a mean follow-up of 14.3 ± 17.6 months, no statistically significant changes were seen in R-wave amplitude (from 8 [6-12] mV to 11.1 [5.6-14.6] mV, p = 0.09, 95% CI 0.26-3.63). Additionally, pacing impedance decreased (from 775±268 Ohms to 448±190 Ohms, p < 0.01, 95% CI 243-373), along with a reduction in pacing threshold (from 1.0 V [0.8-1.5] to 0.7 V [0.5-1], p < 0.01, 95% CI 0.01-0.42). During follow-up, 5 patients (8%) experienced loss of capture due to LBBP lead dislodgement within 4 weeks post-implantation, requiring reintervention. No other adverse events were reported.</p> <p>Conclusion: LBBP has demonstrated to be a safe and feasible pacing modality. The technique offers manageable procedural duration and stable pacing parameters during mid-term follow-up, making it a viable option for patients requiring cardiac pacing. The occurrence of 8% postoperative lead dislodgement demonstrates the importance of the learning curve.</p>
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