Abstract 13251: Left Bundle Branchpacing Post-Atrioventricular Junction Ablation for Atrial Fibrillation: A Propensity Score Matching Analysis

Autor: Weijian Huang, Mengxing Cai, Shengjie Wu, Lan Su, Songjie Wang, Rujie Zheng, Limeng Jiang, Yanlei He, Ling Zhu, Liyou Lian, Kenneth Ellenbogen
Rok vydání: 2021
Předmět:
Zdroj: Circulation. 144
ISSN: 1524-4539
0009-7322
DOI: 10.1161/circ.144.suppl_1.13251
Popis: Introduction: Although left bundle branch pacing (LBBP) has emerged as a novel pacing modality which can allow for safe atrioventricular junction (AVJ) ablation and lower pacing threshold compared to His bundle pacing (HBP), its long-term safety and efficacy in patients with atrial fibrillation (AF) is still unknown. Hypothesis: This study aimed to examine the long-term clinical feasibility, safety, and efficacy of LBBP in AF patients post-AVJ ablation and provide a balanced comparison of LBBP versus HBP. Methods: This study prospectively enrolled patients with AF and heart failure (HF) who underwent AVJ ablation and LBBP from July 2017 to December 2019. The control group patients were selected, by propensity score (PS) matching with a 1:1 ratio, among those HBP implantations performed in the years 2012-2019. Results: A total of 99 patients were enrolled in this study, with successful permanent LBBP post-AVJ ablation in 100% of patients (primary LBBP: 76; secondary LBBP: 23). Significantly improvements were observed in LVEF, tricuspid regurgitation, and mitral regurgitation at 1-year follow-up (pV@0.5ms was 97.9% and only one patient had an increase in threshold ≥1 V@0.5ms at 1-year follow-up. Further, patients with LBBP as an active-group was compared to patients with HBP (control-group) through PS matching with 170 successfully matched (PS-HBP, N=85; PS-LBBP, N=85). In the control-group, the success rate of permanent HBP was 81.9% (176/215), which was lower than that with LBBP (p0.05), while lower thresholds, greater sensed R-wave amplitudes, and less complication were observed in PS-LBBP group (p Conclusions: LBBP is feasible, safe, and effective in AF and HF patients post-AVJ ablation, which has comparable clinical benefit, higher success rate, better pacing parameters, and less complication than HBP.
Databáze: OpenAIRE
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