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Complications of left bundle branch area pacing compared with biventricular pacing in candidates for resynchronization therapy: Results of a propensity score-matched analysis from a multicenter registry.
Complications of left bundle branch area pacing compared with biventricular pacing in candidates for resynchronization therapy: Results of a propensity score-matched analysis from a multicenter registry.
- Source :
-
Heart rhythm [Heart Rhythm] 2024 Jun; Vol. 21 (6), pp. 874-880. Date of Electronic Publication: 2024 Feb 28. - Publication Year :
- 2024
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Abstract
- Background: Cardiac resynchronization therapy (CRT) with biventricular pacing (BVP) is a well-established therapy in patients with reduced left ventricular ejection fraction, heart failure, and left bundle branch block. Left bundle branch area pacing (LBBAP) has recently been shown to be a feasible and effective alternative to BVP. Comparative data on the risk of complications between LBBAP and BVP among patients undergoing CRT are lacking.<br />Objective: The aim of this study was to compare the long-term risk of procedure-related complications between LBBAP and BVP in a cohort of patients undergoing CRT.<br />Methods: This prospective, multicenter, observational study enrolled 668 consecutive patients (mean age 71.2 ± 10.0 years; 52.2% male; 59.4% with New York Heart Association class III-IV heart failure symptoms) with left ventricular ejection fraction 33.4% ± 4.3% who underwent BVP (n = 561) or LBBAP (n = 107) for a class I or II indication for CRT. Propensity score matching for baseline characteristics yielded 93 matched pairs. The rate and nature of intraprocedural and long-term post-procedural complications occurring during follow-up were prospectively collected and compared between the 2 groups.<br />Results: During a mean follow-up of 18 months, procedure-related complications were observed in 16 patients: 12 in BVP (12.9%) and 4 in LBBAP (4.3%) (P = .036). Compared with patients who underwent LBBAP, those who underwent BVP showed a lower complication-free survival (P = .032). In multivariate analysis, BVP resulted an independent predictive factor associated with a higher risk of complications (hazard ratio 3.234; P = .042). Complications related to the coronary sinus lead were most frequently observed in patients who underwent BVP (50.0% of all complications).<br />Conclusion: LBBAP was associated with a lower long-term risk of device-related complications compared with BVP in patients with an indication for CRT.<br />Competing Interests: Disclosures The authors have no conflicts to disclose.<br /> (Copyright © 2024 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Male
Female
Aged
Prospective Studies
Treatment Outcome
Bundle of His physiopathology
Follow-Up Studies
Ventricular Function, Left physiology
Propensity Score
Cardiac Resynchronization Therapy methods
Cardiac Resynchronization Therapy adverse effects
Heart Failure therapy
Heart Failure physiopathology
Bundle-Branch Block therapy
Bundle-Branch Block physiopathology
Registries
Stroke Volume physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1556-3871
- Volume :
- 21
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Heart rhythm
- Publication Type :
- Academic Journal
- Accession number :
- 38428448
- Full Text :
- https://doi.org/10.1016/j.hrthm.2024.02.053