AVB - Atrioventricular Block
Conditions
Keywords
Left bundle branch pacing, Right ventricular pacing, Mortality, Systolic dyssynchrony
Brief summary
Although emerging evidence demonstrated that left bundle branch pacing (LBBP) is a promising alternative for patients with either a bradycardia or a heart failure pacing indication. However, a direct comparison of the safety, efficacy and LV systolic synchrony between LBBP and RVP regimens was rare. In this study, the investigators aim to conduct a comparison of the safety and effectiveness performance between these two pacing methods for patients with atrioventricular block (AVB). The investigators focused on AVB patients undergoing permanent pacemaker implantations from the 1st of January 2018 to the 18th of November 2021 at West China Hospital.
Detailed description
Right ventricular pacing (RVP) is the standard treatment for patients with continuous ventricular pacing needs. However, clinical studies have shown that RVP can cause electrical and mechanical dyssynchrony of the left ventricle and increase the risks of cardiac insufficiency, atrial fibrillation (AF) and death. Although emerging evidence demonstrated that left bundle branch pacing (LBBP) is a promising alternative for patients with either a bradycardia or a heart failure pacing indication. However, a direct comparison of the safety, efficacy and LV systolic synchrony between LBBP and RVP regimens was rare. In this study, the investigators aim to conduct a comparison of the safety and effectiveness performance between these two pacing methods for patients with atrioventricular block (AVB). The investigators focused on AVB patients undergoing permanent pacemaker implantations from the 1st of January 2018 to the 18th of November 2021 at West China Hospital.
Interventions
PROCEDUREleft bundle branch pacing (LBBP)
After recording the His potential, the 3830-69 lead (Medtronic Inc., Minneapolis, MN USA) was sent 1-2 cm forward and downward to find the insertion point of the right side of intra-ventricular septum combined with the pre-rotation impedance and ECG changes. Ultimately, the tip was perpendicularly straightforward posited against the septum to the left septal side .
PROCEDURERight ventricular pacing (RVP)
Right ventricular pacing (RVP) is the standard treatment for patients with continuous ventricular pacing needs.
Sponsors
West China Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* included consecutively high-grade AVB patients undergoing permanent pacemaker implantations from the 1 s t of January 2018 to the 18 thof November 2021 at West China Hospital
Exclusion criteria
* patients with pacemaker replacements were excluded.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| composed of all-cause mortality, lead failure and heart failure hospitalization (HFH) during the follow-ups | through study completion, an average of 2.45 year | composed of all-cause mortality, lead failure and heart failure hospitalization (HFH) during the follow-ups |
| Lead failure | through study completion, an average of 2.45 year | reintervention for increased pacing thresholds, lead dislocation or ventricular perforation after the initial implantation procedure |
| HFH | through study completion, an average of 2.45 year | HFH was defined as the admission to hospital for \>24 hours with worsening symptoms and signs of heart failure and requiring one or more intravenous diuretics or intravenous inotropic medications |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| peri-procedure complication | through study completion, an average of 2.45 year | included pericardial tamponade and pneumothorax |
| cardiac death | through study completion, an average of 2.45 year | documented arrhythmogenic death, an unexpected presumed pulseles condition with the absence of an obvious noncardiac explanation, or a death due to congestive cardiac failure or structural heart disease |
| recurrent unexplained syncope | through study completion, an average of 2.45 year | recurrent unexplained syncope |
Countries
China
Contacts
Primary ContactZhongxiu Chen, Dr
Outcome results
None listed