PMID- 32387225
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210621
IS  - 1916-7075 (Electronic)
IS  - 0828-282X (Linking)
VI  - 37
IP  - 2
DP  - 2021 Feb
TI  - Left Bundle Branch Pacing for Cardiac Resynchronization Therapy: Nonrandomized 
      On-Treatment Comparison With His Bundle Pacing and Biventricular Pacing.
PG  - 319-328
LID - S0828-282X(20)30439-6 [pii]
LID - 10.1016/j.cjca.2020.04.037 [doi]
AB  - BACKGROUND: Left bundle branch pacing (LBBP) is a novel method for delivering 
      cardiac resynchronization therapy (CRT). We compared on-treatment outcomes with 
      His bundle pacing (HBP) and biventricular pacing (BVP) in this nonrandomized 
      observational study. METHODS: Consecutive patients with left-ventricular ejection 
      fraction (LVEF) </= 40% and typical left bundle branch block (LBBB) referred for 
      CRT received BVP, HBP, or LBBP. QRS duration, pacing threshold, LVEF, and New 
      York Heart Association (NYHA) class were assessed. RESULTS: One hundred 
      thirty-seven patients were recruited: 49 HBP, 32 LBBP, and 54 BVP; 2 did not 
      receive CRT. The majority of patients had nonischemic cardiomyopathy. Mean paced 
      QRS duration was 100.7 +/- 15.3 ms, 110.8 +/- 11.1 ms, and 135.4 +/- 20.2 ms during 
      HBP, LBBP, and BVP, respectively. HBP and LBBP demonstrated a similar absolute 
      increase (Delta) in LVEF (+23.9% vs +24%, P = 0.977) and rate of normalized final 
      LVEF (74.4% vs 70.0%, P = 0.881) at 1-year follow-up. This was significantly 
      higher than in the BVP group (Delta LVEF +16.7% and 44.9% rate of normalized final 
      LVEF, P < 0.005). HBP and LBBP also demonstrated greater improvements in NYHA 
      class compared with BVP. LBBP was associated with higher R-wave amplitude (11.2 +/- 
      5.1 mV vs 3.8 +/- 1.9 mV, P < 0.001) and lower pacing threshold (0.49 +/- 0.13 V/0.5 
      ms vs 1.35 +/- 0.73 V/0.5 ms, P < 0.001) compared with HBP. CONCLUSION: LBBP 
      appears to be a promising method for delivering CRT. We observed similar 
      improvements in symptoms and LV function with LBBP and HBP. These improvements 
      were significantly greater than those seen in patients treated with BVP in this 
      nonrandomized study. These promising findings justify further investigation with 
      randomized trials.
CI  - Copyright (c) 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All 
      rights reserved.
FAU - Wu, Shengjie
AU  - Wu S
AD  - Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, China; The Key Lab of Cardiovascular Disease of Wenzhou, 
      Wenzhou, China.
FAU - Su, Lan
AU  - Su L
AD  - Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, China; The Key Lab of Cardiovascular Disease of Wenzhou, 
      Wenzhou, China.
FAU - Vijayaraman, Pugazhendhi
AU  - Vijayaraman P
AD  - Geisinger Heart Institute, Wilkes Barre, Pennsylvania, USA.
FAU - Zheng, Rujie
AU  - Zheng R
AD  - Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, China; The Key Lab of Cardiovascular Disease of Wenzhou, 
      Wenzhou, China.
FAU - Cai, Mengxing
AU  - Cai M
AD  - Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, China; The Key Lab of Cardiovascular Disease of Wenzhou, 
      Wenzhou, China.
FAU - Xu, Lei
AU  - Xu L
AD  - Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, China; The Key Lab of Cardiovascular Disease of Wenzhou, 
      Wenzhou, China.
FAU - Shi, Ruiyu
AU  - Shi R
AD  - Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, China; The Key Lab of Cardiovascular Disease of Wenzhou, 
      Wenzhou, China.
FAU - Huang, Zhouqing
AU  - Huang Z
AD  - Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, China; The Key Lab of Cardiovascular Disease of Wenzhou, 
      Wenzhou, China.
FAU - Whinnett, Zachary I
AU  - Whinnett ZI
AD  - National Heart and Lung Institute, Imperial College London, London, United 
      Kingdom.
FAU - Huang, Weijian
AU  - Huang W
AD  - Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical 
      University, Wenzhou, China; The Key Lab of Cardiovascular Disease of Wenzhou, 
      Wenzhou, China. Electronic address: weijianhuang69@126.com.
LA  - eng
GR  - CS/15/3/31405/BHF_/British Heart Foundation/United Kingdom
GR  - FS/13/44/30291/BHF_/British Heart Foundation/United Kingdom
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20200507
PL  - England
TA  - Can J Cardiol
JT  - The Canadian journal of cardiology
JID - 8510280
SB  - IM
MH  - Aged
MH  - Bundle of His/*physiopathology
MH  - *Bundle-Branch Block/diagnosis/etiology/therapy
MH  - Cardiac Pacing, Artificial/methods
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Female
MH  - *Heart Failure/complications/physiopathology/therapy
MH  - Humans
MH  - Male
MH  - Recovery of Function
MH  - *Stroke Volume
MH  - Symptom Assessment/methods
MH  - Treatment Outcome
MH  - Ventricular Function, Left/physiology
EDAT- 2020/05/11 06:00
MHDA- 2021/06/22 06:00
CRDT- 2020/05/11 06:00
PHST- 2020/02/28 00:00 [received]
PHST- 2020/04/07 00:00 [revised]
PHST- 2020/04/24 00:00 [accepted]
PHST- 2020/05/11 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2020/05/11 06:00 [entrez]
AID - S0828-282X(20)30439-6 [pii]
AID - 10.1016/j.cjca.2020.04.037 [doi]
PST - ppublish
SO  - Can J Cardiol. 2021 Feb;37(2):319-328. doi: 10.1016/j.cjca.2020.04.037. Epub 2020 
      May 7.