Clinical comparison study of peri-left bundle pacing and right ventricular inflow tract septum pacing

Objective The purpose of this study is to compare the short-term clinical effect and electrical parameters of peri-left bundle pacing (peri-LBBP) and right ventricular inflow tract septal pacing (RVIP) . Methods Sixty patients with indications for permanent cardiac pacing and resynchronization therapy were divided into peri-LBBP and RVIP groups in Beijing Anzhen Hospital from April 2017 to September 2018. The Medtronic lead 3830 was used as ventricular pacing lead, and implanted in left ventricular septal sites with left bundle potentials or fascicular potentials in peri-LBBP group and right ventricular inflow tract septal sites closed to distal His-bundle regions without potentials from His-Purkinje conduction system in RVIP group. The lead impedance, R wave amplitude, pacing thresholds, QRS duration, left ventricular ejection fractions (LVEF) , and left ventricular end-diastolic diameter (LVEDD) were compared between two groups during procedure and at 3 month follow-up. Results No statistical significance was found between two groups in R wave amplitude[ (11.2±6.1) mV vs. (9.4±5.4) mV, P=0.255], lead impedance[ (724.0±134.9) Ω vs. (698.5±147.0) Ω, P=0.485], LVEF (56.3%±9.8% vs. 55.7%±9.1%, P=0.796) , LVEDD[ (49.8±8.0) mm vs. (50.6±6.5) mm, P=0.685], QRS duration [ (127.4±32.4) ms vs. (138.3±33.9) ms, P=0.209], QTc [ (461.7±38.5) ms vs. (463.2±35.0) ms, P=0.875], and Tp-e [ (109.5±33.3) ms vs. (109.7±19.0) ms, P=0.974] except pacing thresholds[ (0.7±0.3) mV vs. (0.9±0.4) mV, P=0.021]. Conclusion The efficacy and electrical parameters of peri-LBBP was comparable to RVIP during procedure and in short term follow-up. Key words: Bundle-branch block; Pacemaker, artificial; Right ventricular inflow tract