Left Bundle Branch Area Pacing Prevents New-Onset Atrial Fibrillation and Improves Echocardiographic Parameters Compared with Right Ventricular Pacing in Patients with Bradyarrhythmias
<b>Background/Objectives:</b>Pacing treatment of bradyarrhythmias is both to reduce symptoms and to prevent syncope and sudden cardiac death. The aim of our study was to analyze left bundle branch area pacing (LBBAP) in the prevention of new-onset AF and the improvement of echocardiograp...
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MDPI AG
2025-06-01
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| author | Adrian-Ionuț Ungureanu Georgică Târtea Eugen Țieranu Cristina Elena Negroiu Gianina Cristiana Moise Radu Mitruț Victor Raicea Radu-Gabriel Vătășescu Paul Mitruț |
| author_facet | Adrian-Ionuț Ungureanu Georgică Târtea Eugen Țieranu Cristina Elena Negroiu Gianina Cristiana Moise Radu Mitruț Victor Raicea Radu-Gabriel Vătășescu Paul Mitruț |
| author_sort | Adrian-Ionuț Ungureanu |
| collection | DOAJ |
| description | <b>Background/Objectives:</b>Pacing treatment of bradyarrhythmias is both to reduce symptoms and to prevent syncope and sudden cardiac death. The aim of our study was to analyze left bundle branch area pacing (LBBAP) in the prevention of new-onset AF and the improvement of echocardiographic parameters in patients with mildly reduced left ventricular ejection fraction (LVEF) compared to patients with bradyarrhythmias but preserved LVEF who underwent mid-septal right ventricular pacing. <b>Methods</b>: This research was structured as a retrospective observational cohort study that included 186 patients with LBBAP and 186 patients with RVP, enrolled for 3 years until March 2024 with a follow-up time of 1 year. The primary endpoint of our study was new-onset atrial fibrillation after pacemaker implantation. The secondary endpoint was the improvement of echocardiographic parameters. <b>Results</b>: We observed in the LBBAP group a mean QRS complex duration of 108.7 ± 8.83 ms (after pacemaker implantation), compared to a much longer duration in the RVP group (143.8 ± 9.851 ms, <i>p</i> = <0.0001). At 1 year of follow-up, 22 (11.82%) patients in the RVP group were diagnosed with new-onset atrial fibrillation, compared to 6 (3.22%) patients out of 186 included in the LBBAP group (<i>p</i> = 0.0017). Regarding LVEF, at follow-up, RVP patients had a decrease in LVEF compared to those in the LBBAP group who had an improved LVEF (54.54 ± 3.77%, <i>p</i> < 0.0001). <b>Conclusions</b>: LBBAP both prevents the onset of atrial fibrillation and improves echocardiographic parameters, especially left ventricular ejection fraction, thus contributing to significantly reducing the risk of developing/worsening advanced heart failure through pacing-induced cardiomyopathy. |
| format | Article |
| id | doaj-art-98f33e6d985e4b048a1e1d2c3c8ca40a |
| institution | Matheson Library |
| issn | 2227-9059 |
| language | English |
| publishDate | 2025-06-01 |
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| spelling | doaj-art-98f33e6d985e4b048a1e1d2c3c8ca40a2025-06-25T13:31:41ZengMDPI AGBiomedicines2227-90592025-06-01136137410.3390/biomedicines13061374Left Bundle Branch Area Pacing Prevents New-Onset Atrial Fibrillation and Improves Echocardiographic Parameters Compared with Right Ventricular Pacing in Patients with BradyarrhythmiasAdrian-Ionuț Ungureanu0Georgică Târtea1Eugen Țieranu2Cristina Elena Negroiu3Gianina Cristiana Moise4Radu Mitruț5Victor Raicea6Radu-Gabriel Vătășescu7Paul Mitruț8Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Cardiology, Emergency County Hospital of Craiova, 200642 Craiova, RomaniaDepartment of Cardiology, Emergency County Hospital of Craiova, 200642 Craiova, RomaniaDepartment of Pathophysiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Cardiology, Emergency County Hospital of Craiova, 200642 Craiova, RomaniaDepartment of Cardiology, University and Emergency Hospital, 050098 Bucharest, RomaniaDepartment of Cardiovascular Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Cardiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania<b>Background/Objectives:</b>Pacing treatment of bradyarrhythmias is both to reduce symptoms and to prevent syncope and sudden cardiac death. The aim of our study was to analyze left bundle branch area pacing (LBBAP) in the prevention of new-onset AF and the improvement of echocardiographic parameters in patients with mildly reduced left ventricular ejection fraction (LVEF) compared to patients with bradyarrhythmias but preserved LVEF who underwent mid-septal right ventricular pacing. <b>Methods</b>: This research was structured as a retrospective observational cohort study that included 186 patients with LBBAP and 186 patients with RVP, enrolled for 3 years until March 2024 with a follow-up time of 1 year. The primary endpoint of our study was new-onset atrial fibrillation after pacemaker implantation. The secondary endpoint was the improvement of echocardiographic parameters. <b>Results</b>: We observed in the LBBAP group a mean QRS complex duration of 108.7 ± 8.83 ms (after pacemaker implantation), compared to a much longer duration in the RVP group (143.8 ± 9.851 ms, <i>p</i> = <0.0001). At 1 year of follow-up, 22 (11.82%) patients in the RVP group were diagnosed with new-onset atrial fibrillation, compared to 6 (3.22%) patients out of 186 included in the LBBAP group (<i>p</i> = 0.0017). Regarding LVEF, at follow-up, RVP patients had a decrease in LVEF compared to those in the LBBAP group who had an improved LVEF (54.54 ± 3.77%, <i>p</i> < 0.0001). <b>Conclusions</b>: LBBAP both prevents the onset of atrial fibrillation and improves echocardiographic parameters, especially left ventricular ejection fraction, thus contributing to significantly reducing the risk of developing/worsening advanced heart failure through pacing-induced cardiomyopathy.https://www.mdpi.com/2227-9059/13/6/1374left bundle branch area pacingright ventricular septal pacingnew-onset atrial fibrillationmildly reduced ejection fraction |
| spellingShingle | Adrian-Ionuț Ungureanu Georgică Târtea Eugen Țieranu Cristina Elena Negroiu Gianina Cristiana Moise Radu Mitruț Victor Raicea Radu-Gabriel Vătășescu Paul Mitruț Left Bundle Branch Area Pacing Prevents New-Onset Atrial Fibrillation and Improves Echocardiographic Parameters Compared with Right Ventricular Pacing in Patients with Bradyarrhythmias Biomedicines left bundle branch area pacing right ventricular septal pacing new-onset atrial fibrillation mildly reduced ejection fraction |
| title | Left Bundle Branch Area Pacing Prevents New-Onset Atrial Fibrillation and Improves Echocardiographic Parameters Compared with Right Ventricular Pacing in Patients with Bradyarrhythmias |
| title_full | Left Bundle Branch Area Pacing Prevents New-Onset Atrial Fibrillation and Improves Echocardiographic Parameters Compared with Right Ventricular Pacing in Patients with Bradyarrhythmias |
| title_fullStr | Left Bundle Branch Area Pacing Prevents New-Onset Atrial Fibrillation and Improves Echocardiographic Parameters Compared with Right Ventricular Pacing in Patients with Bradyarrhythmias |
| title_full_unstemmed | Left Bundle Branch Area Pacing Prevents New-Onset Atrial Fibrillation and Improves Echocardiographic Parameters Compared with Right Ventricular Pacing in Patients with Bradyarrhythmias |
| title_short | Left Bundle Branch Area Pacing Prevents New-Onset Atrial Fibrillation and Improves Echocardiographic Parameters Compared with Right Ventricular Pacing in Patients with Bradyarrhythmias |
| title_sort | left bundle branch area pacing prevents new onset atrial fibrillation and improves echocardiographic parameters compared with right ventricular pacing in patients with bradyarrhythmias |
| topic | left bundle branch area pacing right ventricular septal pacing new-onset atrial fibrillation mildly reduced ejection fraction |
| url | https://www.mdpi.com/2227-9059/13/6/1374 |
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