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Comparison of ventricular synchrony in children with left bundle branch area pacing and right ventricular septal pacing

Published online by Cambridge University Press:  05 January 2023

Jinghao Li Open the ORCID record for Jinghao Li [Opens in a new window] ,
He Jiang ,
Jian Cui ,
Yi Zhang Open the ORCID record for Yi Zhang [Opens in a new window] ,
Meiting Li ,
Huiming Zhou  and
Xiaomei Li Open the ORCID record for Xiaomei Li [Opens in a new window]
Jinghao Li
Affiliation:
Department of Pediatric Cardiology, Heart Center, The First Hospital of Tsinghua University (Beijing Huaxin Hospital), Beijing, China School of Clinical Medicine, Tsinghua University, Beijing, China
He Jiang
Affiliation:
Department of Pediatric Cardiology, Heart Center, The First Hospital of Tsinghua University (Beijing Huaxin Hospital), Beijing, China School of Clinical Medicine, Tsinghua University, Beijing, China
Jian Cui
Affiliation:
Department of Pediatric Cardiology, Heart Center, The First Hospital of Tsinghua University (Beijing Huaxin Hospital), Beijing, China
Yi Zhang
Affiliation:
Department of Pediatric Cardiology, Heart Center, The First Hospital of Tsinghua University (Beijing Huaxin Hospital), Beijing, China
Meiting Li
Affiliation:
Department of Pediatric Cardiology, Heart Center, The First Hospital of Tsinghua University (Beijing Huaxin Hospital), Beijing, China
Huiming Zhou
Affiliation:
Department of Pediatric Cardiology, Heart Center, The First Hospital of Tsinghua University (Beijing Huaxin Hospital), Beijing, China School of Clinical Medicine, Tsinghua University, Beijing, China
Xiaomei Li*
Affiliation:
Department of Pediatric Cardiology, Heart Center, The First Hospital of Tsinghua University (Beijing Huaxin Hospital), Beijing, China School of Clinical Medicine, Tsinghua University, Beijing, China
*
Author for correspondence: Xiaomei Li, MD, Department of Pediatric Cardiology, Heart Center, The First Hospital of Tsinghua University (Beijing Huaxin Hospital), No. 6, Jiuxianqiao 1st Road, Chaoyang, Beijing 100016, China. E-mail: lixiaomei1368@sina.com
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Abstract

Objective:

This study aimed to determine the ideal pacing site in children by comparing the postoperative ventricular synchrony in children with left bundle branch area pacing and those with right ventricular septal pacing.

Methods:

This retrospective study included children with complete atrioventricular block who underwent permanent pacemaker implantation from March 2019 to August 2021. Patients were grouped according to their ventricular pacing site, the left bundle branch area pacing group and the right ventricular septal pacing group. Two-dimensional speckle tracking echocardiography was used to evaluate the ventricular synchrony.

Results:

Forty-eight children (median age, 2.7 years; interquartile range, 1.7–4.6 years) were included. The paced QRS duration in the left bundle branch area pacing group was significantly narrower than that in the right ventricular septal pacing group (100.2 ± 9.3 versus 115.4 ± 15.1 ms, p = 0.001). The median follow-up duration was 1.5 years (interquartile range, 1–2 years). At the last follow-up, the average capture threshold of the ventricular electrode in the left bundle branch area pacing group was lower than that in the right ventricular septal pacing group (0.79 ± 0.18 versus 1.20 ± 0.56 V, p = 0.008). The left ventricular intraventricular synchrony parameters in the left bundle branch area pacing group were better than those in the right ventricular septal pacing group (e.g. standard deviation of the time to peak longitudinal strain, 37.4 ± 4.3 versus 46.6 ± 8.2 ms, p = 0.000). The average interventricular mechanical delay time in the left bundle branch area pacing group was significantly shorter than that in the right ventricular septal pacing group (36.4 ± 14.2 versus 52.5 ± 22.7 ms, p = 0.016).

Conclusion:

Compared with right ventricular septal pacing, left bundle branch area pacing in children produces a narrower QRS duration and better pacing and ventricular synchrony parameters postoperatively.

Keywords

Childpacemakerleft bundle branch area pacingventricular synchronyspeckle tracking echocardiography
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 10 , October 2023 , pp. 2078 - 2086
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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Footnotes

Jinghao Li and He Jiang contributed equally to this work and should be regarded as co-first authors.

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