부산대학교 도서관

Background: Left bundle branch area pacing (LBBAP) has emerged as an alternative to biventricular pacing (BVP) for cardiac resynchronization therapy (CRT). We aimed to compare the morbidity and mortality associated with LBBAP versus BVP in patients undergoing CRT implantation.Methods: Consecutive patients who received CRT from two high-volume implantation centers were retrospectively recruited. The primary endpoint was a composite of all-cause death and heart failure hospitalization, and the secondary endpoint was all-cause death.Results: A total of 491 patients receiving CRT (154 via LBBAP and 337 via BVP) were included, with a median follow-up of 31 months. The primary endpoint was reached by 21 (13.6%) patients in the LBBAP group, as compared with 74 (22.0%) patients in the BVP group [hazard ratio (HR) 0.70, 95% confidence interval (CI) 0.43–1.14, P = 0.15]. There were 10 (6.5%) deaths in the LBBAP group, as compared with 31 (9.2%) in the BVP group (HR 0.91, 95% CI 0.44–1.86, P = 0.79). No significant difference was observed in the risk of either the primary or secondary endpoint between LBBAP and BVP after multivariate Cox regression (HR 0.74, 95% CI 0.45–1.23, P = 0.24, and HR 0.77, 95% CI 0.36–1.67, P = 0.51, respectively) or propensity score matching (HR 0.72, 95% CI 0.41–1.29, P = 0.28, and HR 0.69, 95% CI 0.29–1.65, P = 0.40, respectively).Conclusion: LBBAP was associated with a comparable effect on morbidity and mortality relative to BVP in patients with indications for CRT.
Highlights: Left bundle branch area pacing (LBBAP) was associated with a comparable effect on morbidity and mortality relative to biventricular pacing (BVP) in patients with indications for cardiac resynchronization therapy (CRT).LBBAP may serve as a promising alternative to BVP for CRT to improve morbidity and mortality among heart failure patients.Randomized controlled clinical trials with adequate sample size are justified to confirm these findings.