Preliminary study on left bundle branch area pacing in
children:clinical observation of 12 cases
Abstract
Objective: To explore the safety and feasibility of left bundle branch
area pacing (LBBAP) in children. Methods: This study observed 12
children attempted LBBAP from 2019 to 2021 in our department
prospectively. Clinical data, pacing parameters, electrocardiograms,
echocardiographic measurements and complications were recorded at
implant and during follow-up. Results: The 12 patients aged between 3
and 14ys and weighted from 13 to 48kg. 11 patients were diagnosed with
third-degree AVB and 1 patient (case 4) suffered from cardiac
dysfunction due to right ventricular apical pacing (RVAP). LBBAP was
successfully achieved in all patients with narrow QRS complexes. LVEF of
case 4 recovered on the 3rd day after LBBAP. The median of LVEDD Z score
of the 12 patients decreased from 1.75 to1.05 3 months after
implantation (p<0.05). The median of paced QRS duration was
103ms. The median of pacing threshold, R-wave amplitude and impedance
were 0.85V, 15mV and 717Ω respectively and remained stable during
follow-up. No complications such as loss of capture, lead dislodgement
or septal perforation occurred. Conclusions: LBBAP can be performed
safely in children with narrow QRS duration and stable pacing
parameters. Cardiac dysfunction caused by long-term RVAP can be
corrected by LBBAP quickly.