Search

Objective: This systematic review of literature aimed to evaluate the safety and efficacy of dual‐chamber ICDs for LBBAP in patients with left bundle branch block (LBBB). Methods: Digital databases were searched systematically to identify studies reporting the left bundle branch area pacing (LBBAP) with implantable cardioverter defibrillator (ICD) placement in patients with LBBB. Detailed study and patient‐level baseline characteristics including the type of study, sample size, follow‐up, number of cases, age, gender, and baseline characteristics were abstracted. Results: In a total of three studies, 34 patients were included in this review. There was a significant improvement reported in QRS duration in all studies. The mean QRS duration at baseline was 170 ± 17.4 ms, whereas the follow‐up QRS duration at follow‐up was 121 ± 17.3 ms. Two studies reported a significant improvement of 50% in LVEF from baseline. No lead‐related complications or arrhythmic events were recorded in any study. The findings of the systematic review suggest that dual‐chamber ICD for LBBAP is a promising intervention for patients with heart conditions. Conclusion: The procedure offers significant improvements in QRS duration and LVEF, and there were no lead‐related complications or arrhythmic events recorded in any of the studies. [ABSTRACT FROM AUTHOR]

Abstract Objective This systematic review of literature aimed to evaluate the safety and efficacy of dual‐chamber ICDs for LBBAP in patients with left bundle branch block (LBBB). Methods Digital databases were searched systematically to identify studies reporting the left bundle branch area pacing (LBBAP) with implantable cardioverter defibrillator (ICD) placement in patients with LBBB. Detailed study and patient‐level baseline characteristics including the type of study, sample size, follow‐up, number of cases, age, gender, and baseline characteristics were abstracted. Results In a total of three studies, 34 patients were included in this review. There was a significant improvement reported in QRS duration in all studies. The mean QRS duration at baseline was 170 ± 17.4 ms, whereas the follow‐up QRS duration at follow‐up was 121 ± 17.3 ms. Two studies reported a significant improvement of 50% in LVEF from baseline. No lead‐related complications or arrhythmic events were recorded in any study. The findings of the systematic review suggest that dual‐chamber ICD for LBBAP is a promising intervention for patients with heart conditions. Conclusion The procedure offers significant improvements in QRS duration and LVEF, and there were no lead‐related complications or arrhythmic events recorded in any of the studies.

Background: ECG-derived measures of cardiac repolarization may have utility in risk prediction of future ventricular arrhythmia, and a range of different measures have been proposed. We compared time-based, vectorcardiographic, and singular value decomposition (SVD) derived measures of repolarization to determine which was most predictive of appropriate therapy in an ICD population.Methods: We examined the independent prognostic value of a range of repolarization measures derived from 60 second 12-lead ECG recordings in 150 patients receiving new ICD implants in relation to the occurrence of appropriate therapy during follow-up.Results: Over an average follow-up of 2.15 ± 0.87 years, male gender, presence of premature ventricular complex (PVC), relative T wave residuum (TWR-rel, measures regional repolarization heterogeneity), and TCRT (the total cosine R-to-T, describes the global angle between repolarization and depolarization wavefronts) were the only independent predictors of appropriate therapy. With every 0.01% increase in TWR-rel, there was 2% increased risk of appropriate therapy (HR = 1.02, 95% CI 1.006-1.034, P < 0.001). With every 1° decrease in TCRT, there was an increase in arrhythmic risk of 0.9% (HR 1.009, 95% CI 1.003-1.015, P = 0.003).Conclusions: The use of advanced analytic ECG techniques to derive measures of repolarization abnormality might shave utility in risk stratification in an ICD population. [ABSTRACT FROM AUTHOR]