Research on stability of lead parameters by left bundle branch pacing among patients with heart failure and left bundle branch BLOCK
Objective To investigate the stability of electrode parameters in patients with heart failure treated with complete left bun-dle branch block(CLBBB)corrected by left bundle branch pacing(LBBP).Methods A total of 22 patients with sinus rhythm with heart failure with CLBBB(QRS duration≥150 ms)and left ventricular ejection fraction≤35%who were admitted to the Department of Cardiology of General Hospital of Northern Theater Command from January 2019 to June 2020 for cardiac resynchronization treat-ment indications were selected as the study subjects.All enrolled patients gave informed consent to use LBBP to correct CLBBB and the operation was successful.Electrode parameters(threshold and impedance)of LBBP for the correction of CLBBB were recorded im-mediately after surgery and at 1,6,12,24,36 months after surgery.The electrode parameters of LBBP for the correction of CLBBB were followed up.Results All the 22 patients were successfully implanted with LBBP electrodes and CLBBB could be completely correc-ted.There was no statistical significance in pacing threshold values at each time point 1,6,12,24,36 months after surgery and com-pared with pacing threshold values immediately after surgery(P>0.05),and no pacing threshold values more than 2.5 V/0.4 ms.There was no significant difference in the impedance of 22 patients at 1,6,12,24 and 36 months after operation(P>0.05),and all were stable in the normal range,however,they were all lower than the immediate postoperative impedance,and the difference was sta-tistically significant(P<0.05).The QRS duration of postoperative pacing was(114.09±13.68)ms,which was significantly narrower than that of preoperative QRS duration(168.18±9.06)ms,and the difference was statistically significant(P<0.05).No corrective CLBBB pacing loss,3830 lead displacement,perforation,reset,or removal occurred during follow-up,and there was no risk of heart failure rehospitalization or death.Conclusion The electrode parameters of LBBP for the correction of CLBBB is satisfied and has good stability and safety within 3 years.LBBP can significantly narrow QRS wave duration,improve the synchronization of ventricular excita-tion,and achieve the purpose of physiologic pacing to improve heart failure.For patients with heart failure and CLBBB,LBBP may be a reasonable option to correct CLBBB.
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