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The electrocardiogram characteristics and pacing parameters of Permanent left bundle branch area pacing : A systematic review and meta-analysis
  • +2
  • Jia Gao,
  • Bing Zhang,
  • Nan Zhang,
  • Sun Meng,
  • Wang Rui
Jia Gao
Shanxi Medical University
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Bing Zhang
Shanxi Medical University
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Nan Zhang
First Hospital of Shanxi Medical University
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Sun Meng
First Hospital of Shanxi Medical University
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Wang Rui
First Hospital of Shanxi Medical University
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Peer review status:UNDER REVIEW

24 Jun 2020Submitted to Journal of Cardiovascular Electrophysiology
24 Jun 2020Assigned to Editor
24 Jun 2020Submission Checks Completed
26 Jun 2020Reviewer(s) Assigned

Abstract

Background : The invention of His bundle pacing technology bring a new revelation–Left bundle branch area pacing (LBBAP). LBBAP engages in the electrical activation through left bundle branch area and produces ventricular electrical synchronization, which can grab more cardiac cells and increase the safety of pacing compared to His bundle pacing (HBP). This pacing has been considered as an attractive mode to achieve normal physiological pace markers. However,as a new technology, LBBAP is still in the stage of clinical exploration and lacks adequate evaluation. Objective :This study aims to investigate the electrocardiogram characteristics,pacing parameters,the safety and the effectiveness of LBBAP. Method : A computerized search of PubMed, Embase, The CochraneLibrary, Chinese CNKI, CBM, Wanfang and Weipu Chinese Sci-tech Journals database for effects of Left bundle pacing. The baseline characteristics, the successful rate of implantation, capture threshold, R-wave amplitude, pacing impedance, QRS duration and follow-up date were extracted and summarized. Results : Thirteen studies including 618 patients were included in this analysis. The overall successful rate for implantation was 92.1%.Permanent LBBAP resulted in narrow QRS duration when patients with QRS duration>120ms after implantation (P=0.02). QRS duration and capture threshold of LBBAP remained stable during follow-up. Moreover, there was a trend of increased R-wave amplitude and declined pacing impedance at follow-up compared to implantation (P=0.003 and P<0.00001, respectively). Conclusion : Permanent LBBAP has shown promising results in pacemaker-indicated patients. Good electrical synchronization, high success rates, and stable pacemaker parameters point to the unparalleled advantages of LBBAP in physiological pacing.