Imperial College London
Alternate

DrZacharyWhinnett

Faculty of Medicine, National Heart & Lung Institute

Reader in Cardiac Electrophysiology
 
 
 
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Contact

 

z.whinnett

 
 
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Location

 

South- NHLI Cardiovascular ScienceBlock B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Ali:2023:europace/euac245,
author = {Ali, N and Arnold, AD and Miyazawa, AA and Keene, D and Chow, J-J and Little, I and Peters, NS and Kanagaratnam, P and Qureshi, N and Ng, FS and Linton, NWF and Lefroy, DC and Francis, DP and Lim, PB and Tanner, MA and Muthumala, A and Shun-Shin, MJ and Cole, GD and Whinnett, Z},
doi = {europace/euac245},
journal = {EP Europace},
pages = {1060--1067},
title = {Comparison of methods for delivering cardiac resynchronization therapy: an acute electrical and haemodynamic within-patient comparison of left bundle branch area, His bundle, and biventricular pacing},
url = {http://dx.doi.org/10.1093/europace/euac245},
volume = {25},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - AimsLeft bundle branch area pacing (LBBAP) is a promising method for delivering cardiac resynchronization therapy (CRT), but its relative physiological effectiveness compared with His bundle pacing (HBP) is unknown. We conducted a within-patient comparison of HBP, LBBAP, and biventricular pacing (BVP).Methods and resultsPatients referred for CRT were recruited. We assessed electrical response using non-invasive mapping, and acute haemodynamic response using a high-precision haemodynamic protocol. Nineteen patients were recruited: 14 male, mean LVEF of 30%. Twelve had time for BVP measurements. All three modalities reduced total ventricular activation time (TVAT), (ΔTVATHBP -43 ± 14ms and ΔTVATLBBAP −35 ± 20ms vs. ΔTVATBVP −19 ± 30ms, P = 0.03 and P = 0.1, respectively). HBP produced a significantly greater reduction in TVAT compared with LBBAP in all 19 patients (−46 ± 15ms, −36 ± 17ms, P = 0.03). His bundle pacing and LBBAP reduced left ventricular activation time (LVAT) more than BVP (ΔLVATHBP −43 ± 16ms, P < 0.01 vs. BVP, ΔLVATLBBAP −45 ± 17ms, P < 0.01 vs. BVP, ΔLVATBVP −13 ± 36ms), with no difference between HBP and LBBAP (P = 0.65). Acute systolic blood pressure was increased by all three modalities. In the 12 with BVP, greater improvement was seen with HBP and LBBAP (6.4 ± 3.8mmHg BVP, 8.1 ± 3.8mmHg HBP, P = 0.02 vs. BVP and 8.4 ± 8.2mmHg for LBBAP, P = 0.3 vs. BVP), with no difference between HBP and LBBAP (P = 0.8).ConclusionHBP delivered better ventricular resynchronization than LBBAP because right ventricular activation was slower during LBBAP. But LBBAP was not inferior to HBP with respect to LV electrical resynchronization and acute haemodynamic response.
AU  - Ali,N
AU  - Arnold,AD
AU  - Miyazawa,AA
AU  - Keene,D
AU  - Chow,J-J
AU  - Little,I
AU  - Peters,NS
AU  - Kanagaratnam,P
AU  - Qureshi,N
AU  - Ng,FS
AU  - Linton,NWF
AU  - Lefroy,DC
AU  - Francis,DP
AU  - Lim,PB
AU  - Tanner,MA
AU  - Muthumala,A
AU  - Shun-Shin,MJ
AU  - Cole,GD
AU  - Whinnett,Z
DO  - europace/euac245
EP  - 1067
PY  - 2023///
SN  - 1099-5129
SP  - 1060
TI  - Comparison of methods for delivering cardiac resynchronization therapy: an acute electrical and haemodynamic within-patient comparison of left bundle branch area, His bundle, and biventricular pacing
T2  - EP Europace
UR  - http://dx.doi.org/10.1093/europace/euac245
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000925175500001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://academic.oup.com/europace/advance-article/doi/10.1093/europace/euac245/7025387?login=true
UR  - http://hdl.handle.net/10044/1/102249
VL  - 25
ER  -
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