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A Study to Analyse the Feasibility and Effectiveness of Left Bundle Branch Area Pacing Used in Young Children

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Abstract

This study aimed to investigate the feasibility and effectiveness of left bundle branch area pacing (LBBaP) in young children. From September 2020 to May 2021, a total of 31 children (≤ 7 years) with complete atrioventricular block were included. All patients were scheduled to undergo LBBaP. Pacing parameters, and cardiac function and synchrony were evaluated during follow-up. LBBaP succeeded in 21 children (3.3 ± 2.1 years old), with a success rate of 70.9%. LBBaP failed in nine children, who eventually received right ventricular septal pacing (RVSP). The average postoperative QRS duration in patients of LBBaP group was narrower than that of RVSP group: 100.9 ± 9.1 versus 114.2 ± 11.9 ms (P = 0.002). The median follow-up duration was 12 [interquartile range (IQR) 6–15] months. At last time of follow-up, the capture threshold of ventricular electrode in patients of LBBaP group were significantly lower than that of RVSP group (0.70 ± 0.25 versus 1.39 ± 0.94 V, P = 0.011). The echo-left ventricular ejection fraction (LVEF) in patients in the LBBaP group was better than that in the RVSP group (66.1 ± 3.3 versus 63.1 ± 2.2%, P = 0.025). LBBaP can be safely and effectively administered in young children. Satisfactory pacing parameters, and narrow QRS durations were obtained.

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References

  1. Siu C, Wang M, Zhang X et al (2008) Analysis of ventricular performance as a function of pacing site and mode. Prog Cardiovasc Dis 51:171–182. https://doi.org/10.1016/j.pcad.2008.01.001

    Article  PubMed  Google Scholar 

  2. Gebauer RA, Tomek V, Salameh A et al (2009) Predictors of left ventricular remodelling and failure in right ventricular pacing in the young. Eur Heart J 30:1097–1104. https://doi.org/10.1093/eurheartj/ehp060

    Article  PubMed  PubMed Central  Google Scholar 

  3. Safak E, Ince H, Gkouvatsou L et al (2019) Pacing-induced cardiomyopathy in chronic right ventricular apical pacing: a midterm follow-up study. Eur J Med Res 24:23–28. https://doi.org/10.1186/s40001-019-0386-5

    Article  PubMed  PubMed Central  Google Scholar 

  4. Li X, Qiu C, Xie R et al (2020) Left bundle branch area pacing delivery of cardiac resynchronization therapy and comparison with biventricular pacing. ESC Heart Fail 7:1711–1722. https://doi.org/10.1002/ehf2.12731

    Article  PubMed  PubMed Central  Google Scholar 

  5. Vijayaraman P, Subzposh FA, Naperkowski A et al (2019) Prospective evaluation of feasibility and electrophysiologic and echocardiographic characteristics of left bundle branch area pacing. Heart Rhythm 16:1774–1782. https://doi.org/10.1016/j.hrthm.2019.05.011

    Article  PubMed  Google Scholar 

  6. Shah MJ, Silka MJ, Avari SJ et al (2021) 2021 PACES expert consensus statement on the indications and management of cardiovascular implantable electronic devices in pediatric patients. Indian Pacing Electrophysiol J 21:367–393. https://doi.org/10.1016/j.hrthm.2021.07.038

    Article  PubMed  PubMed Central  Google Scholar 

  7. Michele B, Angelo A, Gonzalo BE et al (2013) 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur Heart J 34:2281–2329. https://doi.org/10.1093/eurheartj/eht150

    Article  Google Scholar 

  8. Zhang J, Wang Z, Cheng L et al (2019) Immediate clinical outcomes of left bundle branch area pacing vs conventional right ventricular pacing. Clin Cardiol 42:768–773. https://doi.org/10.1002/clc.23215

    Article  PubMed  PubMed Central  Google Scholar 

  9. Huang W, Su L, Wu S et al (2017) A novel pacing strategy with low and stable output: pacing the left bundle branch immediately beyond the conduction block. Can J Cardiol 33:e1–e3. https://doi.org/10.1016/j.cjca.2017.09.013

    Article  ADS  Google Scholar 

  10. Ponnusamy SS, Arora V, Namboodiri N et al (2020) Left bundle branch pacing: a comprehensive review. J Cardiovasc Electr 31:2462–2473. https://doi.org/10.1111/jce.14681

    Article  Google Scholar 

  11. Zhang S, Zhou X, Gold MR (2019) Left bundle branch pacing: JACC review topic of the week. J Am Coll Cardiol 74:3039–3049. https://doi.org/10.1016/j.jacc.2019.10.039

    Article  PubMed  Google Scholar 

  12. Jimenez E, Zaban N, Sharma N et al (2020) His bundle and left bundle pacing in pediatrics and congenital heart disease: a single center experience. Pediatr Cardiol 41:1425–1431. https://doi.org/10.1007/s00246-020-02398-9

    Article  PubMed  Google Scholar 

  13. Dai C, Dai W, Guo B (2020) Clinical observation on six children of left bundle branch area pacing. Chin J Pediatr 58:107–112. https://doi.org/10.3760/cma.j.issn.0578-1310.2020.02.008

    Article  CAS  Google Scholar 

  14. Jiang H, Hou X, Qian Z et al (2020) A novel 9-partition method using fluoroscopic images for guiding left bundle branch pacing. Heart Rhythm 17:1759–1767. https://doi.org/10.1016/j.hrthm.2020.05.018

    Article  PubMed  Google Scholar 

  15. Abdelrahman M, Subzposh FA, Beer D et al (2018) Clinical outcomes of his bundle pacing compared to right ventricular pacing. J Am Coll Cardiol 71:2319–2330. https://doi.org/10.1016/j.jacc.2018.02.048

    Article  PubMed  Google Scholar 

  16. Guo J, Li L, Meng F et al (2020) Short-term and intermediate-term performance and safety of left bundle branch pacing. J Cardiovasc Electr 31:1472–1481. https://doi.org/10.1111/jce.14463

    Article  Google Scholar 

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Acknowledgements

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Funding

This study was funded by Dr. Wu Shunde Foundation for Research in Medical Science, Grant No. 20240000811.

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Author notes

  1. Jinghao Li and He Jiang contributed equally to this work and should be regarded as co-first authors.

Authors and Affiliations

  1. Department of Paediatric Cardiology, Heart Center, The First Hospital of Tsinghua University (Beijing Huaxin Hospital), No.6, Jiuxianqiao 1st Road, Chaoyang, Beijing, 100016, China

    Jinghao Li, He Jiang, Yi Zhang, Jian Cui, Meiting Li, Huiming Zhou & Xiaomei Li

  2. School of Clinical Medicine, Tsinghua University, Beijing, China

    Jinghao Li, He Jiang, Huiming Zhou & Xiaomei Li

Authors
  1. Jinghao Li
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  2. He Jiang
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  3. Yi Zhang
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  4. Jian Cui
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  5. Meiting Li
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  6. Huiming Zhou
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  7. Xiaomei Li
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Contributions

JL performed manuscript writing and clinical data analysis. XL and HJ performed manuscript revision and supervision. HJ, YZ, and JC participated in the methodology. ML and HZ participated in clinical data collection.

Corresponding author

Correspondence to Xiaomei Li.

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Conflict of interest

Authors declare that they have no conflict of interest.

Ethical Approval

This is an observational study. All procedures involving human participants were performed in accordance with the ethical standards of the institution and the Helsinki Declaration of 1964. This study was approved by the Ethics Committee of our hospital (Ethics Document Batch Number:202003).

Informed Consent

Every patient provided an informed consent form and an anaesthesia consent form. Consent forms were signed by the patient’s guardian prior to pacemaker implantation.

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Not applicable.

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Li, J., Jiang, H., Zhang, Y. et al. A Study to Analyse the Feasibility and Effectiveness of Left Bundle Branch Area Pacing Used in Young Children. Pediatr Cardiol 45, 681–689 (2024). https://doi.org/10.1007/s00246-023-03119-8

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  • DOI: https://doi.org/10.1007/s00246-023-03119-8

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