Meta-Analysis Comparing Safety and Efficacy of Left Bundle Branch Area Pacing Versus His Bundle Pacing
The American Journal of Cardiology, ISSN: 0002-9149, Vol: 164, Page: 64-72
2022
- 16Citations
- 15Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Metrics Details
- Citations16
- Citation Indexes16
- 16
- CrossRef4
- Captures15
- Readers15
- 15
Article Description
Although His bundle pacing (HBP) can provide a physiologic ventricular activation pattern, it has disadvantages such as the difficulty of lead implantation, reduced R wave amplitudes, and high and unstable pacing thresholds. Recent studies have demonstrated that left bundle branch area pacing (LBBaP) might overcome these deficiencies. A total of 7 nonrandomized controlled studies including 786 patients (n = 442 receiving LBBaP and n = 344 receiving HBP) with bradyarrhythmia were evaluated. Compared with HBP, LBBaP appeared to result in increased R wave amplitudes (at implant: MD 9.84 mV, 95% confidence interval [CI] 7.61 to 12.06 mV; at follow-up: MD 7.62 mV, 95% CI 6.73 to 8.50 mV), lowered capture thresholds (at implant: MD −0.73 V, 95% CI −0.81 to −0.64 V; at follow-up: MD −0.71 V, 95% CI −0.92 to −0.50 V), shortened procedure times (MD −16.70 minutes, 95% CI −26.51 to −6.90 minutes) and fluoroscopic durations (MD −6.16 min, 95% CI −8.28 to −4.03 minutes), and increased success rates (odds ratio 2.14, 95% CI 1.23 to 3.74); all of these differences were significant. However, paced QRS durations, the lead impedance at implantation and follow-up, and incidence of lead-related complications such as lead dislodgement did not significantly differ between LBBaP and HBP. In conclusion, current evidence suggests that LBBaP is a potential alternative to HBP as a pacing modality with which to maintain an ideal physiologic pattern of ventricular activation through native His–Purkinje system stimulation.
Bibliographic Details
http://www.sciencedirect.com/science/article/pii/S0002914921010560; http://dx.doi.org/10.1016/j.amjcard.2021.10.025; http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85120716655&origin=inward; http://www.ncbi.nlm.nih.gov/pubmed/34887071; https://linkinghub.elsevier.com/retrieve/pii/S0002914921010560; https://dx.doi.org/10.1016/j.amjcard.2021.10.025
Elsevier BV
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