New-Onset Left Ventricular Dysfunction After Left Bundle Branch Pacing.

Autor:	Ponnusamy SS; Department of Cardiology, Velammal Medical College Hospital and Research Institute, Madurai, India. Electronic address: shunmuga.pgi@gmail.com., Ganesan V; Department of Microbiology, Velammal Medical College and Research Institute, Madurai, India., Nagalingam S; Medtronic India Private Limited, India., Ramalingam V; Department of Cardiology, Velammal Medical College Hospital and Research Institute, Madurai, India., Mariappan S; Department of Cardiology, Velammal Medical College Hospital and Research Institute, Madurai, India., Moghal H; Department of Cardiology, Velammal Medical College Hospital and Research Institute, Madurai, India., Murugan S; Department of Cardiology, Velammal Medical College Hospital and Research Institute, Madurai, India., Kumar M; Department of Cardiology, Velammal Medical College Hospital and Research Institute, Madurai, India., Joseph R; Department of Cardiology, Velammal Medical College Hospital and Research Institute, Madurai, India., Vijayaraman P; Geisinger Heart Institute, Geisinger Commonwealth School of Medicine, Wilkes Barre, Pennsylvania, USA.
Jazyk:	angličtina
Zdroj:	JACC. Clinical electrophysiology [JACC Clin Electrophysiol] 2024 Nov; Vol. 10 (11), pp. 2494-2502. Date of Electronic Publication: 2024 Sep 25.
DOI:	10.1016/j.jacep.2024.07.019
Abstrakt:	Background: Left bundle branch pacing (LBBP) provides stable pacing parameters and has been suggested as an alternative for right ventricular pacing and cardiac resynchronization therapy. Objectives: The aim of the study was to assess the incidence and etiology of new-onset left ventricular dysfunction (NOLVD) following LBBP in patients with baseline normal left ventricular (LV) function and cardiomyopathy patients with normalized LV function. Methods: Patients undergoing successful LBBP for symptomatic bradyarrhythmia or as an alternative to cardiac resynchronization therapy were included. Normalization of LV function was defined as improvement in LV ejection fraction to ≥50%. Patients with baseline normal LV function and those with recovered LV function after LBBP constituted the study group. Loss of conduction system capture (LOCSC) was defined as complete or partial loss of right bundle branch delay pattern along with inability to demonstrate capture transition during threshold assessment. Results: A total of 426 patients were included; 59% (n = 250) had baseline normal LV function (group I) and 41% (n = 176) had recovered LV function after LBBP (group II). Mean follow-up duration of 28.3 ± 16.7 months. NOLVD was noted in 3.75% (n = 16; group I, n = 5, and group II, n = 11) of patients. The etiologies for NOLVD were LOCSC in 62.5% (n = 10), suboptimal atrioventricular (AV) delay in 18.7% (n = 3), atrial fibrillation in 6.3% (n = 1), and idiopathic in 12.5% (n = 2). LOCSC occurred at a mean interval of 9.2 ± 6.4 months after the initial implantation. Reinterventions (n = 6) including lead repositioning, AV delay optimization, and AV junction ablation resulted in renormalization of LV function in all 6 patients. Conclusions: Periodic assessment in device clinic is required because NOLVD from reversible causes can occur during follow-up in patients after LBBP. Competing Interests: Funding Support and Author Disclosures Dr Ponnusamy has served as a consultant for and performed research for Medtronic; and has served as a consultant for Abbott. Dr Vijayaraman has served as a speaker and consultant for, performed research for, and received fellowship support from Medtronic; has served as a consultant for Abbott, Biotronik, and Boston Scientific; and has a patent for an HBP delivery tool. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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