Short QRS Duration After His-Purkinje Conduction System Pacing Predicts Left Ventricular Complete Reverse Remodeling in Patients With True Left Bundle Branch Block and Heart Failure

• DOI: 10.3389/fcvm.2022.824194
• Publication Date: 2022-05-06T05:38:54Z
• Authors: Xu-Min Guan; Dan-Na Li; Fu-Lu Zhao; Yan-Ni Zhao; Yi-Heng Yang; Bai-Ling Dai; Shi-Yu Dai; Lian-Jun Gao; Yun-Long Xia; Ying-Xue Dong
• Keywords: Bundle branch block; Ventricular remodeling

This study aimed to explore the outcomes of His-Purkinje conduction system pacing (HPCSP) and screen predictors left ventricular (LV) complete reverse remodeling in patients with true bundle branch block (LBBB) heart failure reduced ejection fraction (HFrEF).Patients who underwent HPCSP for LBBB HFrEF from April 2018 August 2020 were consecutively enrolled. All participants followed up at least 1 year. Thrombosis, infection, lead dislodgement, perforation, other complications observed after HPCSP. Clinical data, including echocardiographic parameters, electrocardiogram measurements, cardiac function, assessed before procedure.A total 46 was successfully deployed 42 cases (91.30%), which included 37 His (HBP) 5 (LBBP). The QRS duration decreased significantly (169.88 ± 19.17 ms vs. 113.67 20.68 ms, P < 0.001). Left end-systolic volume (LVESV) (167.67 73.20 ml 85.97 62.24 ml, 0.001), end-diastolic diameter (LVEDD) (63.57 8.19 mm 55.46 9.63 mm, = 0.003) (LVEF) (26.52 5.60% 41.86 11.56%, 0.001) improved dramatically. Complete LV normalized LVEF LVEDD found nearly half (45.24%). A short a strong predictor (P thresholds increased markedly two approximately 6 months HBP. No died during follow-up period 20.07 6.45 months.Complete could be HPCSP, predictor.