Effect Of Left Bundle Branch Pacing Compared With Left Ventricular Septal Pacing On Left Ventricular Systolic Synchronization In Patients

Objective: To compare the effects of left bundle branch pacing(LBBP)and left ventricular septum pacing(LVSP)on left ventricular systolic synchronization in patients,so as to provide the basis for clinical selection of appropriate pacing therapy.Methods: An observational single-center prospective study design was adopted in this study.According to the admission criteria,a total of 50 patients who successfully implemented left bundle branch pacing or left ventricular septal pacing in our hospital were selected,including30 patients in left bundle branch pacing group and 20 patients in left ventricular septal pacing group.The baseline data of the two groups were recorded and compared,and the patients were followed up within three days after operation and 1 months after operation.The echocardiography parameter,electrocardiogram,chest radiograph data were recorded in each follow-up period.Echocardiography parameters(peak strain dispersion,PSD and longitudinal systolic peak strain,GLS)for evaluating the synchronization of left ventricular are obtained by two-dimensional speckle tracking imaging technology.Finally,the data are statistically analyzed.Results: There was no difference in baseline data between LBBP group and LVSP group.The peak time and QRS duration in the left bundle branch pacing group were shorter than those in the left ventricular septal pacing group,and the difference was statistically significant.There was no significant difference in the proportion of ventricular pacing between the two groups 3days after operation.The proportion of ventricular pacing in the left bundle branch pacing group was higher than that in the left ventricular septal pacing group 1 month after operation,and the difference was statistically significant.There was no significant difference in PSD value,GLS absolute value,left ventricular ejection fraction and left ventricular size between the two groups in pacing mode 3 days after operation and 1 month after operation.One month after operation,the pulmonary artery pressure in the left bundle branch pacing group was lower than that in the self-conduction state,and the difference was statistically significant.In pacing mode,there was no significant difference in PSD and GLS between the two groups at3 days after operation.One month after operation,the PSD of patients in the left bundle branch pacing group was smaller than that in the left ventricular septal pacing group,and the absolute value of GLS was larger,with statistical significance.There was no significant difference in QRS duration and cardiothoracic ratio between patients with left bundle branch pacing group and patients with left ventricular septal pacing group at 3 days and 1 month after operation.Mitral and tricuspid regurgitation were similar in both pacing mode and self mode.During the follow-up period,there was no significant change in NYHA rating in both groups,and no serious complications occurred after operation.Conclusion: Compared with left ventricular septal pacing,left bundle branch pacing can maintain left ventricular contraction synchronization better,and can provide patients with a more physiological ventricular excitation mode.It is possible to obtain a longer-term beneficial clinical outcome by implementing left bundle branch pacing in non-heart failure patients with the indications of common dual-chamber pacemaker.