Comparative Study Of LBBaP And RVSP In Patients With Third Degree AVB

Objective:To investigate the feasibility,safety,and specific advantages of left bundle branch area pacing(LBBa P)in patients with third-degree atrioventricular block(AVB)compared with right ventricular septal pacing(RVSP).Methods:In a retrospective study,56 patients who were admitted with a dualchamber permanent pacemaker with third-degree AVB were selected,where26 underwent LBBa P and 30 received RVSP.Preoperative and postoperative QRS wavewidth were compared.Preoperative and postoperative the left atrial anteroposterior diameter(LAAD)、 the left ventricular end-diastolic anteroposterior diameter(LVEDD)and the left ventricular ejection fraction(LVEF)values at 3 and 6 months were measured in Ultrasonic cardiogram.Intraoperative and postoperative ventricular parameters at 3 and 6 months were also measured in programmer.Preoperative and postoperative NTpro BNP at 1 week,1 month,3 months,and 6 months were compared.Intraoperative and postoperative complications were counted.Results:1.ECG QRS wave width:The postoperative QRS wavewidth in the LBBa P group was narrower than that in the RVSP group(P = 0.000).2.Ventricular electrode parameters:Ventricular electrode thresholds,impedances and perception in the two groups were within the normal range.In particular the threshold value in the LBBa P group did not increase postoperatively.3.Echocardiographic findings:The LAAD and LVEDD values in the LBBa P group were lower postoperatively than those in the RVSP group at 6months(P < 0.05).The LVEF values in the LBBa P group were higher than those in the RVSP group at 6 months postoperatively(P < 0.05).4.NT-pro BNP:At 3 months postoperatively,the NT-pro BNP values in the LBBa P group were significantly lower than those in the RVSP group(P <0.05),which widened further at 6 months postoperatively(P < 0.05).5.Comparison of complications:There was no statistical difference in the probability of complications between the two groups(P = 1.000).Conclusions:Compared with RVSP,LBBa P is a safe physiological better pacing modality.