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Left bundle branch pacing on mechanical synchrony and myocardial work in bradycardia patients

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Abstract

Left bundle branch pacing (LBBP) has emerged as a novel physiological pacing method to produce narrower QRS duration, but whether it could restore mechanical synchrony and improve myocardial work still lacks sufficient evidence. Therefore, the goal of this study was to evaluate mechanical synchrony and myocardial work in LBBP. We collected 20 patients with LBBP due to symptomatic bradycardia and another 29 age-matched patients with right ventricular pacing (RVP). For LBBP patients, cardiac electro-mechanical synchrony and myocardial work were measured at baseline and 7 days after implantation and compared with the RVP patients. In the LBBP group, paced QRS duration and mechanical synchrony were not significantly different from baseline(all P > 0.05), but significantly smaller than that in the RVP group (all P<0.05). Meanwhile, global longitudinal strain (GLS) in LBBP was greater than that in the RVP group (17.7 ± 3.5% vs. 14.8 ± 3.1%, P < 0.05). Global myocardial work index and global constructive work were also better than that in the RVP group(all P<0.05). Global work efficiency was 91.9 ± 3.1%, which was greater when compared with RVP (P < 0.05). LBBP provides better cardiac electro-mechanical synchrony and more effective myocardial work than that in RVP, thus improving global heart function.

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Funding

This study was supported by the National Natural Science Foundation of China (Grant to Qiong Qiu, No. 81700359).

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Authors and Affiliations

  1. Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yan Jiang West Road, 510120, Guangzhou, China

    PeiWei Wang, Li Yang, ShaoXin Zheng, JingTing Mai, YuLing Wei, YingMei Liu, BingQing Deng, HanLu Lv, YangXin Chen & Qiong Qiu

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  1. PeiWei Wang
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by PeiWei Wang, Li Yang, ShaoXin Zheng, and JingTing Mai. The first draft of the manuscript was written by PeiWei Wang, Qiong Qiu and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to YangXin Chen or Qiong Qiu.

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This study was granted by the Ethics Committee of the Sun Yat-sen Memorial Hospital of Sun Yat-sen University (SYSEC-KY-KS-2020-134).

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Wang, P., Yang, L., Zheng, S. et al. Left bundle branch pacing on mechanical synchrony and myocardial work in bradycardia patients. Int J Cardiovasc Imaging 39, 369–378 (2023). https://doi.org/10.1007/s10554-022-02742-5

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