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Ravi V, Sharma PS, Patel NR, Dommaraju S, Zalavadia DV, Garg V, Larsen TR, Naperkowski AM, Wasserlauf J, Krishnan K, Young W, Pokharel P, Oren JW, Storm RH, Trohman RG, Huang HD, Subzposh FA, Vijayaraman P. New-Onset Atrial Fibrillation in Left Bundle Branch Area Pacing Compared With Right Ventricular Pacing. Circ Arrhythm Electrophysiol 2022; 15:e010710. [PMID: 35333096 DOI: 10.1161/circep.121.010710] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Venkatesh Ravi
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, IL (V.R., P.S.S., V.G., T.R.L., J.W., K.K., R.G.T., H.G.H.)
| | - Parikshit S Sharma
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, IL (V.R., P.S.S., V.G., T.R.L., J.W., K.K., R.G.T., H.G.H.)
| | - Neil R Patel
- Wright Center for GME, Scranton, PA (N.R.P., S.D.)
| | | | - Dipen V Zalavadia
- Geisinger Heart Institute, Wilkes Barre, PA (D.V.Z., A.M.N., F.A.S., P.V.)
| | - Varun Garg
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, IL (V.R., P.S.S., V.G., T.R.L., J.W., K.K., R.G.T., H.G.H.)
| | - Timothy R Larsen
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, IL (V.R., P.S.S., V.G., T.R.L., J.W., K.K., R.G.T., H.G.H.)
| | | | - Jeremiah Wasserlauf
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, IL (V.R., P.S.S., V.G., T.R.L., J.W., K.K., R.G.T., H.G.H.)
| | - Kousik Krishnan
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, IL (V.R., P.S.S., V.G., T.R.L., J.W., K.K., R.G.T., H.G.H.)
| | | | - Parash Pokharel
- Geisinger Heart Institute, Danville, PA (P.P., J.W.O., R.H.S.)
| | - Jess W Oren
- Geisinger Heart Institute, Danville, PA (P.P., J.W.O., R.H.S.)
| | - Randle H Storm
- Geisinger Heart Institute, Danville, PA (P.P., J.W.O., R.H.S.)
| | - Richard G Trohman
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, IL (V.R., P.S.S., V.G., T.R.L., J.W., K.K., R.G.T., H.G.H.)
| | - Henry D Huang
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, IL (V.R., P.S.S., V.G., T.R.L., J.W., K.K., R.G.T., H.G.H.)
| | - Faiz A Subzposh
- Geisinger Heart Institute, Wilkes Barre, PA (D.V.Z., A.M.N., F.A.S., P.V.)
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Sharma PS, Patel NR, Ravi V, Zalavadia DV, Dommaraju S, Garg V, Larsen TR, Naperkowski AM, Wasserlauf J, Krishnan K, Young W, Pokharel P, Oren JW, Storm RH, Trohman RG, Huang HD, Subzposh FA, Vijayaraman P. Clinical outcomes of left bundle branch area pacing compared to right ventricular pacing: Results from the Geisinger-Rush Conduction System Pacing Registry. Heart Rhythm 2021; 19:3-11. [PMID: 34481985 DOI: 10.1016/j.hrthm.2021.08.033] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/09/2021] [Accepted: 08/30/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Left bundle branch area pacing (LBBAP) has been shown to be a feasible option for patients requiring ventricular pacing. OBJECTIVE The purpose of this study was to compare clinical outcomes between LBBAP and RVP among patients undergoing pacemaker implantation METHODS: This observational registry included patients who underwent pacemaker implantations with LBBAP or RVP for bradycardia indications between April 2018 and October 2020. The primary composite outcome included all-cause mortality, heart failure hospitalization (HFH), or upgrade to biventricular pacing. Secondary outcomes included the composite endpoint among patients with a prespecified burden of ventricular pacing and individual outcomes. RESULTS A total of 703 patients met inclusion criteria (321 LBBAP and 382 RVP). QRS duration during LBBAP was similar to baseline (121 ± 23 ms vs 117 ± 30 ms; P = .302) and was narrower compared to RVP (121 ± 23 ms vs 156 ± 27 ms; P <.001). The primary composite outcome was significantly lower with LBBAP (10.0%) compared to RVP (23.3%) (hazard ratio [HR] 0.46; 95%T confidence interval [CI] 0.306-0.695; P <.001). Among patients with ventricular pacing burden >20%, LBBAP was associated with significant reduction in the primary outcome compared to RVP (8.4% vs 26.1%; HR 0.32; 95% CI 0.187-0.540; P <.001). LBBAP was also associated with significant reduction in mortality (7.8% vs 15%; HR 0.59; P = .03) and HFH (3.7% vs 10.5%; HR 0.38; P = .004). CONCLUSION LBBAP resulted in improved clinical outcomes compared to RVP. Higher burden of ventricular pacing (>20%) was the primary driver of these outcome differences.
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Affiliation(s)
- Parikshit S Sharma
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, Illinois
| | | | - Venkatesh Ravi
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, Illinois
| | | | | | - Varun Garg
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, Illinois
| | - Timothy R Larsen
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, Illinois
| | | | - Jeremiah Wasserlauf
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, Illinois
| | - Kousik Krishnan
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, Illinois
| | - Wilson Young
- Geisinger Heart Institute, Scranton, Pennsylvania
| | | | - Jess W Oren
- Geisinger Heart Institute, Danville, Pennsylvania
| | | | - Richard G Trohman
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, Illinois
| | - Henry D Huang
- Division of Cardiac Electrophysiology, Rush University Medical Center, Chicago, Illinois
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