Clinical efficacy of upgrading to left bundle branch area pacing in patients with pacing-induced cardiomyopathy
WANG Yunfei
GU Xiang
ZHU Ye
Abstract：Objective To explore the safety and long-term efficacy of pacing-induced cardiomyopathy(PICM)patients with left bundle branch area pacing(LBBAP).Methods A retrospective study was conducted on 13 PICM patients undergoing routine pacemaker upgrade to cardiac resynchronization therapy(CRT)in Department of Cardiovascular Medicine of Northern Jiangsu People's Hospital from January 2018 to January 2024.According to different CRT procedures,the patients were divided into LBBAP group(n=5)and biventricular pacing group(BiVP,n=8).All of them were followed up for at least 1 year in outpatient clinic.The changes in QRS duration(QRSd),left atrial dimension(LAD),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF),N-terminal pro-B-type natriuretic peptide(NT-proBNP),New York Heart Association(NYHA)cardiac function class,and pacing threshold were compared before and in 12 month after surgery and between the two groups.The CRT response rate,and incidences of postoperative complications and adverse events during follow-up were recorded.Results Compared with the levels before the upgrade,both group obtained significantly reduced QRSd,LAD,LVEDD and LVESD and NT-proBNP level,and improved LVEF and NYHA cardiac function class in 12 months after the upgrade(P<0.05,P<0.01).But there were no statistical differences in QRSd,LAD,LVEDD,LVESD,LVEF,NT-proBNP,and NYHA cardiac function class between the LBBAP group and the BiVP group(P>0.05).In 12 months after surgery,the CRT response rate was 80%(4/5)in the LBBAP group and 62.5%(5/8)in the BiVP group,but no significant difference was found between them(P>0.05).Conclusion LBBAP upgrading therapy results in stable long-term thresholds in PICM patients,and achieves good electro-mechanical synchronization.It shows no significant differences from BiVP in improving cardiac function and clinical efficacy,which can be used as an alternative choice for these patients.
Keywords：cardiac resynchronization therapyheart failureleft bundle branch area pacingpacing-induced cardiomyopathy
Publication Date：2026-02-15
Online Publishing Date：2026-03-11(First online date of this platform, not the publication date of the document)
Pages：5( 176-180 )