1.INTRODUCTION
cardiac pacing technology as a
therapy has been used for over a half century and it remains the most
effective therapy for bradycardia and cardiac conduction
dysfunction.Traditionally, the pacing site at the apex of the right
ventricle has been chosen because of the ease of placement of
transvenous pacing leads. Several studies conducted over the past two
decades have shown that right ventricular pacing (RVP)has adverse
effects on clinical outcomes because of ventricular mechanical
asynchrony which is secondary to electrical
asynchrony1–3. The Pursuit of alternate pacing sites
has been widely studied but no definitive conclusion is
reached4. In 2000, Deshmukh conducted the pioneering
investigation of permanent direct His bundle
pacing(HBP)5.Since then, more and more studies
showed that HBP is superior in preserving electrical synchrony and left
ventricular(LV)function compared to right ventricular pacing
(RVP)6,7. However, lead placement for HBP is a
technically challenging due to its anatomic location, and long-term
capture thresholds of HBP have been found to be significantly higher
than those of RVP. In 2017, Huang Weijian proposed left bundle branch
area pacing (LBBAP) firstly8.
Some clinical trials have
demonstrated that left bundle branch area pacing exhibited the
feasibility for patient with left bundle branch block (LBBB)/heart
failure and showed more stable and reliable pacing parameters,but these
trials mostly were small sample,short-term studies. LBBAP may be a
potential physiological pacing method that can replaces HBP, but it
lacks of clinical application and requires to investigate the
electrocardiogram characteristics, pacing parameters ,the safety and the
effectiveness .
So we systematically reviewed currently available literature and carried
out this meta-analysis: (i) to investigate the electrocardiogram
characteristics change (ii)to report the stability of pacing
parameters and (iii)to summuerize the successful rate of LBBAP from
kinds of articles. The reporting of this systematic review follows
current standards.