The Research Of The Short-term Efficacy And Safety Of Left Bundle Branch Pacing In The Treatment Of Patients With Atrioventricular Block

Objective(s):This research aims to evaluate the fesibility,safety,QRS duration,cardiac fuction,cardiac synchrony of the left bundle branch area pacing in patients with three degree atrioventricular block.Methods:From January to December 2019,A total of 40 patients with atrioventricular block,admitted to the Department of Cardiology,the first affiliated hospital of Kunming Medical University,were recruited for our study.Patients were randomly divided into the LBBaP group and conventional RVAP group,including LBBaP group(n=20),RVAP group(n=20)?The pacing parameters?QRS wave duration?left ventricular ejection fraction(LVEF)?aortic valvula velocity time integral(AVTI),Interventricular synchronization IVMD?the standard deviation of Ts of 12 segments peak time(Ts-SD12)were compared between two groups at 1 and 6 month follow-up.Results:1.Compared with the duration of QRS wave duration before and after operation in each group:RVAP group(159.45±6.43ms vs 106.50±6.62ms,P<0.001);LBBaP group(112.95±7.47ms vs 104.40±.13ms,P<0.001).?Post operative QRS wave duration among two groups:RVAP group vs LBBaP group(159.45±6.43ms vs 112.95±7.47ms,P<0.001).2.There were no significant changes in pacing threshold,impedance and perception among the two groups after surgery,or compared after surgery with before surgery(P>0.05).3.The indexes of left ventricular systolic were evaluated in the two groups after surgery,and there was no significant difference between the two groups(P>0.05).4.In the RVAP group,the index IVMD after surgery was significantly longer than before surgery(39.65±5.45 ms vs 24.05±6.02ms,P<0.001),In the LBBaP group,index IVMD was slightly longer than before surgery(25.10±5.25ms VS 21.70±4.70ms,P>0.05);The comparison between two groups about in index IVMD:LBBaP group vs RVAP group(25.10±5.25ms vs 39.65±5.45 ms,P<0.001);5.Ts-SD 12,an index for evaluating left ventricular synchronization,was longer than before surgery in RVAP group(44.55±8.51ms vs 24.40±5.51ms,P<0.01).There was no significant change in left ventricular synchronization after operation in LBBaP group(LBBaP group 21.20±4.88ms vs 23.80±5.88ms,P=0.182).The intra-left ventricular synchronization was different among the two groups after operation.(RVAP group vs LBBaP group,44.55±8.51ms vs 21.20±4.88ms,P<0.01);Conclusion(s):1.LBBaP is a safe?effective?physiological pacing strategy for patients who are diagnosed with AVB;2.Compared with RVAP,LBBP can better maintain interventricular and left ventricular synchronization.