左束支起搏与传统右室起搏对房室传导阻滞患者近期疗效观察及安全性评估

doi:10.20047/j.issn1673-7210.2023.26.16

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Abstract Objective To compare the efficacy and safety of left bundle branch pacing and conventional pacing in patients with atrioventricular block. Methods A total of 174 patients with atrioventricular block who were admitted to the Department of Cardiology, Anqing Hospital, Anhui Medical University and underwent cardiac pacemaker implantation from January 2020 to June 2021 were selected as the research objects. The patients were divided into the traditional right ventricular pacing group (right ventricular apex pacing) and the left bundle branch pacing group (left bundle branch pacing) according to random number table method, with 87 cases in each group. Left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), serum brain natriuretic peptide (BNP), pacing parameter threshold, impedance, perception, and QRS duration were compared between the two groups during operation, 1 month, and 12 months after surgery. The left ventricle 12 segments Ts standard deviation (Tsd-12-LV) and the difference between left ventricular lateral wall base segments and right ventricular free wall base systolic velocity peak time（Ts） (Ts-LV-RV), left ventricular filling time(LVFT) and RR interval ratio (LVFT/RR), as well as operation time, radiation exposure time, radiation dose, and patient complications. Results LVEDD and BNP levels in traditional right ventricular pacing group 12 months after surgery were higher than those before surgery and one month after surgery, and the differences were statistically significant (P＜0.05); BNP level in left bundle branch pacing group 12 months after operation was lower than that in traditional right ventricular pacing group, and the difference was statistically significant (P＜0.05). There were statistically significant differences in threshold comparison between two groups at different points, and the perceptual ability 12 months after surgery was higher than that during surgery and one month after surgery, the differences were statistically significant (P＜0.05); the duration of QRS wave in left bundle branch pacing group during operation, 1 month and 12 months after operation were lower than that in traditional right ventricular pacing group during the same period, and the differences were statistically significant (P＜0.05). The Tsd-12-LV, Ts-LV-RV, and LVFT/RR values of the two groups 12 months after surgery were lower than those before surgery, and the differences were statistically significant (P＜0.05); the LVFT/RR in the traditional right ventricular pacing group at 12 months after surgery was lower than that at one month after surgery, and the difference was statistically significant (P＜0.05). The Ts-LV-RV value and LVFT/RR value in the left bundle branch pacing group at 12 months after surgery were lower than those at one month after surgery, and the differences were statistically significant (P＜0.05). Tsd-12-LV, Ts-LV-RV, and LVFT/RR in left bundle branch pacing group were lower than those in traditional right ventricular pacing group at 12 months after surgery, and the differences were statistically significant (P＜0.05). The Ts-LV-RV value in left bundle branch pacing group was lower than that in traditional right ventricular pacing group one month after operation, and the differences were statistically significant (P＜ 0.05). The operation time and radiation exposure time in the left bundle branch pacing group were longer than those in the traditional right ventricular pacing group, and the radiation dose was higher than that in the traditional right ventricular pacing group, the differences were statistically significant (P＜0.05). The incidence of complications in the left bundle branch pacing group was lower than that in the traditional right ventricular pacing group, and the difference was statistically significant (P＜0.05). Conclusion Left bundle branch pacing is better than traditional pacing in reducing the threshold level of atrioventricular block, and the QRS wave is stable. Left bundle branch pacing can avoid the deterioration of cardiac function, maintain normal left ventricular synchrony, and is safe.

Key words： Atrioventricular block Left bundle branch pacing Traditional right ventricular pacing Curative effect Security

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	CHEN Liangchuan XU Lu ZHU Xianguan XIANG Xuejun ZHENG Yuanxi QIAO Rui▲

Cite this article:

CHEN Liangchuan XU Lu ZHU Xianguan XIANG Xuejun ZHENG Yuanxi QIAO Rui▲. Evaluation of efficacy and safety of left bundle branch pacing and traditional right ventricular pacing in patients with atrioventricular block[J]. 中国医药导报, 2023, 20(26): 76-81.

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https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2023.26.16 OR https://www.yiyaodaobao.com.cn/EN/Y2023/V20/I26/76

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