Left bundle branch area pacing versus endocardial resynchronization in patients with heart failure.
Background: Left bundle branch area pacing (LBBAP) and endocardial resynchronization (Endo‐CRT) are alternatives to biventricular pacing for cardiac resynchronization therapy (CRT). Objective: To compare the outcomes of LBBAP versus Endo‐CRT using conventional pacing leads. Methods: Patients with he...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 36; no. 1; pp. 135 - 144 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Jan2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=183983595&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 183983595 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Jan2025 vid: 36 iid: 1 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 183983595 180715955 183983595 183983595 10.1111/jce.16479 183983595 ppf: 135 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Left bundle branch area pacing versus endocardial resynchronization in patients with heart failure. aug: au: Diaz, Juan Carlos Bastidas, Oriana Aristizabal, Julian Marin, Jorge Niño, Cesar Moreno, Sebastian Ruiz, Luis Miguel Caceres, Manuel Jaraba, Elmer Cabanillas, Nestor Duque, Mauricio affil: Division of Cardiology, Cardiac Arrhythmia and Electrophysiology Service, Clinica Las Vegas, Medellin, Colombia sug: subj: Heart Failure Therapy Bundle-Branch Block Cardiac Pacing, Artificial Cardiac Resynchronization Therapy Treatment Outcomes Evaluation Human Comparative Studies Hospitalization Patient Safety Electrocardiography Male Female Middle Age Aged Fluoroscopy Descriptive Statistics Confidence Intervals Odds Ratio Ventricular Ejection Fraction Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: Left bundle branch area pacing (LBBAP) and endocardial resynchronization (Endo‐CRT) are alternatives to biventricular pacing for cardiac resynchronization therapy (CRT). Objective: To compare the outcomes of LBBAP versus Endo‐CRT using conventional pacing leads. Methods: Patients with heart failure (HF) undergoing CRT with LBBAP or Endo‐CRT were included. The primary efficacy outcome was a composite of HF‐related hospitalization and all‐cause mortality. The primary safety outcome was any procedure‐related complication. Secondary outcomes included procedural characteristics, electrocardiographic, and echocardiographic parameters. Results: A total of 223 patients (LBBAP n = 197, Endo‐CRT n = 26; mean age 69 ± 10.3 years, 32.3% female) were included. Patients in the LBBAP group had lower NYHA class, shorter preprocedural QRS durations (161 [142–183] vs. 180 [170–203] msec, p <.001), and a lower preprocedural spironolactone use (57.4% vs. 84.6%, p =.009) than patients in the Endo‐CRT group. Fluoroscopy time was significantly shorter in patients undergoing LBBAP (11.4 [7.2–20] vs. 23 [14.2–34.5] min; p <.001). There was no significant difference in the primary efficacy outcome between both groups (Cox proportional HR 1.21, 95% CI 0.635–2.31; p =.56). During follow‐up, patients undergoing LBBAP had a lower incidence of stroke than patients in the Endo‐CRT group (0% vs. 11.5%, p =.001). Postprocedural LVEF (35% [25–45] vs. 40% [20–55]; p =.307) and change in LVEF (7% [0–20] vs. 11% [2–18]; p =.384) were similar between the LBBAP and the Endo‐CRT groups, respectively. Conclusion: LBBAP and Endo‐CRT using conventional leads are associated with similar mortality and HF‐related hospitalization, as well as improvements in LVEF. Endo‐CRT is associated with longer fluoroscopy times and a higher risk of stroke. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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