His bundle pacing versus left bundle branch pacing on ventricular function in atrial fibrillation patients referred for pacing: a prospective crossover comparison

Yang YE; Bo GAO; Yuan LV; Tian-Tian XU; Si-Si ZHANG; Xiao-Li LU; Ying YANG; Dong-Mei JIANG; Yi-Wen PAN; Xia SHENG; Bei WANG; Yan-Kai MAO; Zu-Wen ZHANG; Shi-Quan CHEN; Jie-Fang ZHANG; Li WANG; Jiang-Fen JIANG; Ya-Xun SUN; Yan MA; Fei-Ling WANG; Min WANG; Hong HE; Chen-Yang JIANG; Guo-Sheng FU

doi:10.26599/1671-5411.2023.01.006

Volume 20 Issue 1

Jan. 2023

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Article Navigation > Journal of Geriatric Cardiology > 2023 > 20(1): 51-60

Please cite this article as: YE Y, GAO B, LV Y, XU TT, ZHANG SS, LU XL, YANG Y, JIANG DM, PAN YW, SHENG X, WANG B, MAO YK, ZHANG ZW, CHEN SQ, ZHANG JF, WANG L, JIANG JF, SUN YX, MA Y, WANG FL, WANG M, HE H, JIANG CY, FU GS. His bundle pacing versus left bundle branch pacing on ventricular function in atrial fibrillation patients referred for pacing: a prospective crossover comparison J Geriatr Cardiol 2023; 20(1): 51−60. DOI: 10.26599/1671-5411.2023.01.006

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Please cite this article as: YE Y, GAO B, LV Y, XU TT, ZHANG SS, LU XL, YANG Y, JIANG DM, PAN YW, SHENG X, WANG B, MAO YK, ZHANG ZW, CHEN SQ, ZHANG JF, WANG L, JIANG JF, SUN YX, MA Y, WANG FL, WANG M, HE H, JIANG CY, FU GS. His bundle pacing versus left bundle branch pacing on ventricular function in atrial fibrillation patients referred for pacing: a prospective crossover comparison J Geriatr Cardiol 2023; 20(1): 51−60. DOI: 10.26599/1671-5411.2023.01.006

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His bundle pacing versus left bundle branch pacing on ventricular function in atrial fibrillation patients referred for pacing: a prospective crossover comparison

doi: 10.26599/1671-5411.2023.01.006

1.
Department of Cardiology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
2.
Department of Cardiology, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, China
3.
Department of Cardiology, Lishui People’s Hospital, Lishui, Zhejiang Province, China
4.
Department of Cardiology, Ningbo Ninth Hospital, Ningbo, Zhejiang Province, China
5.
Department of Cardiology, Anji people’s Hospital, Ningbo, Zhejiang Province, China
6.
Department of Diagnostic Ultrasound and Echocardiography, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China

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Corresponding author: fugs@zju.edu.cn
Available Online: 2023-02-06
Publish Date: 2023-01-28

Abstract

Abstract

BACKGROUND His bundle pacing (HBP) and left bundle branch pacing (LBBP) both provide physiologic pacing which maintain left ventricular synchrony. They both improve heart failure (HF) symptoms in atrial fibrillation (AF) patients. We aimed to assess the intra-patient comparison of ventricular function and remodeling as well as leads parameters corresponding to two pacing modalities in AF patients referred for pacing in intermediate term. METHODS Uncontrolled tachycardia AF patients with both leads implantation successfully were randomized to either modality. Echocardiographic measurements, New York Heart Association (NYHA) classification, quality-of-life assessments and leads parameters were obtained at baseline and at each 6-month follow up. Left ventricular function including the left ventricular endo-systolic volume (LVESV), left ventricular ejection fraction (LVEF) and right ventricular (RV) function quantified by tricuspid annular plane systolic excursion (TAPSE) were all assessed. RESULTS Consecutively twenty-eight patients implanted with both HBP and LBBP leads successfully were enrolled (69.1 ± 8.1 years, 53.6% male, LVEF 59.2% ± 13.7%). The LVESV was improved by both pacing modalities in all patients (n = 23) and the LVEF was improved in patients with baseline LVEF at less than 50% (n = 6). The TAPSE was improved by HBP but not LBBP (n = 23). CONCLUSION In this crossover comparison between HBP and LBBP, LBBP was found to have an equivalent effect on LV function and remodeling but better and more stable parameters in AF patients with uncontrolled ventricular rates referred for atrioventricular node (AVN) ablation. HBP could be preferred in patients with reduced TAPSE at baseline rather than LBBP.

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References(30)

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