Preoperative QRS Duration Predicts the Responsiveness of Chronic Heart Failure Patients with Pacemaker Indications to Left Bundle Branch Area Pacing Treatment

Authors

  • Tian-ping Chen Department of Cardiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
  • Xu Geng Department of Cardiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
  • Ya-xing Fang Department of Cardiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
  • Yu-chun Yin Department of Cardiology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
  • Nai-ju Zhang Department of Pharmacy, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China

DOI:

https://doi.org/10.1532/hsf.4743

Keywords:

Chronic heart failure, left bundle branch block, cardiac resynchronization therapy, left bundle branch regional pacing

Abstract

Background: This study investigated the predictive value of preoperative QRS duration (QRSd) in responsiveness of chronic heart failure (CHF) patients with pacemaker indications to the left bundle branch area pacing (LBBAP).

Methods: Thirty-one CHF patients with cardiac function categorized as NYHA class II or above and indications for pacemaker therapy who successfully underwent LBBAP treatment were enrolled in this study. Based on the 12-month postoperative responsiveness to treatment, patients were divided into a responsiveness group (N = 16) and a no-responsiveness group (N = 15). Data from all patients were collected for analysis. Multivariate binary logistic regression analysis was used to determine the independent factors associated with the responsiveness to LBBAP treatment.

Results: Among the 31 patients with LBBAP, 16 patients (51.6%) responded to the treatment, and 15 patients (48.4%) had no response. There were significant differences between the two groups with regard to complete left bundle branch block (CLBBB), preoperative QRSd, and preoperative left ventricular peak time (LVAT). Univariate logistic regression analysis showed that CLBBB, preoperative QRSd, and preoperative LVAT all were significantly correlated with responsiveness to LBBAP. Multivariate binary logistic regression analysis showed that QRSd was an independent predictor of responsiveness to LBBAP. The maximum area under the ROC curve for QRSd was 0.827 (95%C.I.:0.663-0.991), the maximum Youden index was 0.679, with the optimal cutoff point of QRSd ≥ 153 ms, a sensitivity of 81.3%, and a specificity of 86.7%.

Conclusion: Preoperative QRSd predicts the responsiveness of CHF patients with pacemaker indications to LBBAP.

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Published

2022-07-15

How to Cite

Chen, T.- ping, Geng, X., Fang, Y.- xing, Yin, Y.- chun ., & Zhang, N.- ju. (2022). Preoperative QRS Duration Predicts the Responsiveness of Chronic Heart Failure Patients with Pacemaker Indications to Left Bundle Branch Area Pacing Treatment. The Heart Surgery Forum, 25(4), E553-E558. https://doi.org/10.1532/hsf.4743

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