Left Bundle Branch Area Pacing Prevents New-Onset Atrial Fibrillation and Improves Echocardiographic Parameters Compared with Right Ventricular Pacing in Patients with Bradyarrhythmias
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Patient Selection
2.2. Implant Procedure
2.3. Data Collection and Follow-Up
2.4. Study Endpoints
2.5. Statistical Analysis
3. Results
3.1. Baseline Characteristics of All Enrolled Patients
3.2. Radiation Dosage and Procedural Duration
3.3. Electrocardiographic Parameters
3.4. New-Onset Atrial Fibrillation
3.5. Echocardiographic Outcomes
3.6. Follow-Up of Pacing Parameters
4. Discussion
Limitations of Our Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | RVP (n = 186) | LBBAP (n = 186) | p Value | |
---|---|---|---|---|
Gender | Male | 100 (53.76%) | 113 (60.75%) | 0.2085 # |
Female | 86 (46.24%) | 73 (39.25%) | ||
Indication for implant | Sick sinus syndrome | 39 (20.97%) | 54(29.03%) | 0.0934 # |
AV block | 147 (79.03%) | 132 (70.97%) | ||
Age (years) | 71.03 ± 9.08 | 70.80 ± 8.96 | 0.8006 * | |
Smoke | Yes | 29 (15.59%) | 37 (19.89%) | 0.3421 # |
Hypertension | Yes | 102 (48.34%) | 109 (51.66%) | 0.5302 # |
Heart failure | NYHA I/II | 167 (89.78%) | 151 (81.18%) | 0.0266 # |
NYHA III/IV | 19 (10.22%) | 35 (18.82%) | ||
Coronary artery disease | Yes | 10 (5.38%) | 24 (12.90%) | 0.0182 # |
Diabetes mellitus | Yes | 63 (33.87%) | 60 (32.26%) | 0.8256 # |
Hemoglobin (g/dL) | 13.72 ± 1.637 | 13.63 ± 1.741 | 0.5958 * | |
Creatinine (mg/dL) | 1.209 ± 0.4234 | 1.275 ± 0.4848 | 0.1586 * | |
Echo parameters | ||||
LVEF (%) | 55.43 ± 3.25 | 42.62 ± 2.34 | <0.0001 * | |
LVEDD (mm) | 45.23 ± 4.03 | 48.52 ± 4.52 | <0.0001 * | |
LAV (mL) | 75.00 ± 21.07 | 87.39 ± 30.98 | <0.0001 * | |
LAEF (%) | 49.31 ± 7.67 | 45.30 ± 9.09 | <0.0001 * |
The Time of Assessment | Parameters | RVP Group (n = 186) | LBBAP Group (n = 186) | p Value * |
---|---|---|---|---|
At implant | Impedance (ohm) | 579.8 ± 73.93 | 547.5 ± 66.89 | <0.0001 |
Pacing threshold (V/0.4 ms) | 0.7245 ± 0.1792 | 0.6008 ± 0.1409 | <0.0001 | |
R-wave amplitude (mV) | 10.82 ± 4.427 | 12.98 ± 4.438 | <0.0001 | |
1-month follow-up | Atrial pacing (%) | 28.44 ± 32.99 | 25.93 ± 31.84 | 0.4566 |
Ventricular pacing (%) | 70.73 ± 28.80 | 80.54 ± 24.10 | 0.0004 | |
Impedance (ohm) | 580.1 ± 75.00 | 523.5 ± 72.31 | <0.0001 | |
Pacing threshold (V/0.4 ms) | 0.7419 ± 0.1926 | 0.6129 ± 0.1645 | <0.0001 | |
R-wave amplitude (mV) | 9.923 ± 4.361 | 13.31 ± 4.355 | <0.0001 | |
3-month follow-up | Atrial pacing (%) | 29.19 ± 32.80 | 26.77 ± 31.62 | 0.4684 |
Ventricular pacing (%) | 71.52 ± 30.20 | 83.61 ± 22.73 | <0.0001 | |
Impedance (ohm) | 565.2 ± 76.58 | 504.1 ± 72.65 | <0.0001 | |
Pacing threshold (V/0.4 ms) | 0.7567 ± 0.2037 | 0.6397 ± 0.1799 | <0.0001 | |
R-wave amplitude (mV) | 9.805 ± 4.381 | 13.12 ± 4.415 | <0.0001 | |
6-month follow-up | Atrial pacing (%) | 32.24 ± 33.41 | 29.85 ± 32.02 | 0.4822 |
Ventricular pacing (%) | 70.70 ± 30.59 | 82.79 ± 23.26 | <0.0001 | |
Impedance (ohm) | 566.2 ± 75.99 | 478.0 ± 82.12 | <0.0001 | |
Pacing threshold (V/0.4 ms) | 0.7648 ± 0.2193 | 0.6359 ± 0.2015 | <0.0001 | |
R-wave amplitude (mV) | 9.199 ± 4.344 | 13.15 ± 4.198 | <0.0001 | |
12-month follow-up | Atrial pacing (%) | 30.45 ± 32.85 | 28.01 ± 31.57 | 0.4654 |
Ventricular pacing (%) | 69.76 ± 30.54 | 81.73 ± 23.33 | <0.0001 | |
Impedance (ohm) | 558.5 ± 77.43 | 442.8 ± 82.96 | <0.0001 | |
Pacing threshold (V/0.4 ms) | 0.7917 ± 0.2395 | 0.6720 ± 0.2368 | <0.0001 | |
R-wave amplitude (mV) | 9.046 ± 4.112 | 13.82 ± 4.252 | <0.0001 |
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Ungureanu, A.-I.; Târtea, G.; Țieranu, E.; Negroiu, C.E.; Moise, G.C.; Mitruț, R.; Raicea, V.; Vătășescu, R.-G.; Mitruț, P. Left Bundle Branch Area Pacing Prevents New-Onset Atrial Fibrillation and Improves Echocardiographic Parameters Compared with Right Ventricular Pacing in Patients with Bradyarrhythmias. Biomedicines 2025, 13, 1374. https://doi.org/10.3390/biomedicines13061374
Ungureanu A-I, Târtea G, Țieranu E, Negroiu CE, Moise GC, Mitruț R, Raicea V, Vătășescu R-G, Mitruț P. Left Bundle Branch Area Pacing Prevents New-Onset Atrial Fibrillation and Improves Echocardiographic Parameters Compared with Right Ventricular Pacing in Patients with Bradyarrhythmias. Biomedicines. 2025; 13(6):1374. https://doi.org/10.3390/biomedicines13061374
Chicago/Turabian StyleUngureanu, Adrian-Ionuț, Georgică Târtea, Eugen Țieranu, Cristina Elena Negroiu, Gianina Cristiana Moise, Radu Mitruț, Victor Raicea, Radu-Gabriel Vătășescu, and Paul Mitruț. 2025. "Left Bundle Branch Area Pacing Prevents New-Onset Atrial Fibrillation and Improves Echocardiographic Parameters Compared with Right Ventricular Pacing in Patients with Bradyarrhythmias" Biomedicines 13, no. 6: 1374. https://doi.org/10.3390/biomedicines13061374
APA StyleUngureanu, A.-I., Târtea, G., Țieranu, E., Negroiu, C. E., Moise, G. C., Mitruț, R., Raicea, V., Vătășescu, R.-G., & Mitruț, P. (2025). Left Bundle Branch Area Pacing Prevents New-Onset Atrial Fibrillation and Improves Echocardiographic Parameters Compared with Right Ventricular Pacing in Patients with Bradyarrhythmias. Biomedicines, 13(6), 1374. https://doi.org/10.3390/biomedicines13061374