The impact of left bundle branch area pacing compared to right ventricular septal pacing on cardiac function and quality of life in elderly patients with high percentage of ventricular pacing
HUANG Juan
ZHANG Chengwei
BI Songjie
WU Qi
Abstract：Objective To explore the effects of left bundle branch pacing(LBBaP)and right ventricular septal pacing(RVSP)on cardiac structure,function and quality of life in elderly patients with high proportion of ventricular pacing.Methods A total of 70 patients over 65 years old with grade Ⅱ type Ⅱ,high,third degree atrioventricular block requiring permanent pacing treatment from June 2020 to June 2023 in department of cardiology of 416 Hospital of the Nuclear Industry were randomly divided into LBBaP group(n=35)and RVSP group(n=35)with Random Number Table,and then operate LBBaP and RVSP respectively.QRS wave width,pacing parameters,cardiac structure parameters,cardiac function indicators and comprehensive geriatric assessment scales data of all patients were collected.Results ①There were no statistically significant differences in the ventricular electrode parameters(perception,impedance,threshold,ventricular pacing ratio)between the two groups of patients during and 6 months after surgery(P>0.05).②Compared to the RVSP group,the LBBaP group had a significantly lower plasma BNP value(P<0.05)and a significantly higher 6MWT value(P<0.05)at 6 months after surgery.③Compared to the RVSP group,the QRS wave width in the LBBaP group was significantly narrower immediately after surgery(P<0.01).④There were no significant differences in cardiac ultrasound indicators(LAD,LVEDD,RAD,RVEDD,LVEF,etc)between the two groups before and 6 months after surgery.However,there were statistically significant differences in the indicators of ΔEF and E/A values>1 between the two groups(P<0.01,P<0.05).⑤The Barthel scores and MNA scores of the LBBaP group were significantly higher than those of the RVSP group at 6 months after surgery(P<0.05,P<0.05).The GDS scores of the LBBaP group were lower than those of the RVSP group at 1 month and at 6 months after surgery(P<0.01,P<0.05).There were no statistically significant differences in MMSE scores between the two groups at each stage before and after surgery.Conclusion LBBaP has stable pacing parameters and can maintain good electro-mechanical synchronization,which is superior to RVSP in improving cardiac function and quality of life in elderly patients with high proportion of ventricular pacing.LBBaP is an ideal pacing method for elderly patients with atrioventricular block.
Keywords：atrioventricular blockleft bundle branch area pacingright ventricular septal pacingcardiac function
Publication Date：2025-10-20
Online Publishing Date：2025-12-03(First online date of this platform, not the publication date of the document)
Pages：7( 1213-1218,1222 )