| Objective: To compared and analyzed the ECG characteristics,pacing parameters and cardiac ultrasound indexes of patients with left bundle branch pacing and routine right ventricular pacing,and to explore the effectiveness and safety of left bundle branch pacing.Methods: Retrospective analysis on November 14,2019 to February 28,2021 in Department of Cardiology/CCU of the Second Affiliated Hospital of Guangxi Medical University successful underwent left bundle branch area of pacing patients clinical data(33 cases in total),and the clinical data of patients who underwent routine right ventricular pacing(right ventricular apex/middle right ventricular outflow tract)at the same period and in the past(33 cases in total).Follow-up for 3 months time,analysis of the patient’s clinical basic characteristics,intraoperative pacing threshold and impedance of each electrode,operation time,R/P wave amplitude,preoperative and postoperative electrocardiogram QRS group duration,preoperative and postoperative cardiac ultrasound indicators(including at the end of the left ventricular end-diastolic diameter,left ventricular systolic diameter,left ventricular ejection fraction),have again without heart failure hospitalization following surgery and the postoperative complications,etc.Results: After data comparative analysis,it was found that there were no significant differences in gender,age,diagnosis and other basic characteristics of patients and surgical complications between the two groups.The operative time of left bundle branch pacing group(133.64±44.41min)was not significantly different from that of normal right ventricular pacing group(119.55±38.66min)(P > 0.05).The preoperative QRS duration difference between the two groups was statistically insignificant(P > 0.05),but the postoperative QRS duration of the left bundle branch pacing group(118.79±17.23ms)was significantly reduced compared with that of the conventional right ventricular pacing group(135.70±27.46ms),P < 0.01.Although the difference in preoperative and postoperative QRS duration between the two groups was statistically insignificant,the postoperative QRS duration of routine right ventricular pacing tended to be wider than that of preoperative QRS duration.When combined with complete left bundle branch block,the duration of QRS group after surgery(121.20±11.37ms)was significantly shorter than that before surgery(163.20±15.53ms),P < 0.01.Compared with the conventional right ventricular pacing group(147.11±17.44ms),it was shorter(P < 0.05).The threshold value of left bundle branch pacing electrode(0.81±0.28V)was higher than that of conventional right ventricular pacing electrode(0.66±0.22V),P < 0.05.There were no significant differences in right ventricular(left beam branch)electrode impedance,R wave amplitude,right atrial pacing threshold,impedance and P wave amplitude between the two groups(P > 0.05).In the follow-up 3 months,the parameters of heart color ultrasound were analyzed,and it was found that the left ventricular end-diastolic diameter after surgery was reduced in both groups compared with that before surgery,and the difference was significant in the conventional right ventricular pacing group,P < 0.05.The differences in left ventricular end-diastolic diameter before and after the left bundle branch pacing group,left ventricular end-systolic diameter and LVEF value(%)before and after the two groups were statistically insignificant(P > 0.05).The differences of left ventricular end-diastolic diameter,left ventricular end-systolic diameter and left ventricular ejection fraction(LVEF%)between the two groups before and after operation were statistically insignificant(P > 0.05).Conclusion: The left ventricular synchronization of left bundle branch region pacing was better than that of conventional right ventricular pacing.When combined with left bundle branch block,the therapeutic effect is better,and it is a safe and effective pacing mode. |
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