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Left Bundle Branch Pacing Versus Right Ventricular Pacing in Patients With Atrioventricular Block

Recruiting
Conditions
AVB - Atrioventricular Block
Interventions
Procedure: left bundle branch pacing (LBBP)
Procedure: Right ventricular pacing (RVP)
Registration Number
NCT05722379
Lead Sponsor
West China Hospital
Brief Summary

Although emerging evidence demonstrated that left bundle branch pacing (LBBP) is a promising alternative for patients with either a bradycardia or a heart failure pacing indication. However, a direct comparison of the safety, efficacy and LV systolic synchrony between LBBP and RVP regimens was rare. In this study, the investigators aim to conduct a comparison of the safety and effectiveness performance between these two pacing methods for patients with atrioventricular block (AVB). The investigators focused on AVB patients undergoing permanent pacemaker implantations from the 1st of January 2018 to the 18th of November 2021 at West China Hospital.

Detailed Description

Right ventricular pacing (RVP) is the standard treatment for patients with continuous ventricular pacing needs. However, clinical studies have shown that RVP can cause electrical and mechanical dyssynchrony of the left ventricle and increase the risks of cardiac insufficiency, atrial fibrillation (AF) and death. Although emerging evidence demonstrated that left bundle branch pacing (LBBP) is a promising alternative for patients with either a bradycardia or a heart failure pacing indication. However, a direct comparison of the safety, efficacy and LV systolic synchrony between LBBP and RVP regimens was rare. In this study, the investigators aim to conduct a comparison of the safety and effectiveness performance between these two pacing methods for patients with atrioventricular block (AVB). The investigators focused on AVB patients undergoing permanent pacemaker implantations from the 1st of January 2018 to the 18th of November 2021 at West China Hospital.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
1000
Inclusion Criteria
  • included consecutively high-grade AVB patients undergoing permanent pacemaker implantations from the 1 s t of January 2018 to the 18 thof November 2021 at West China Hospital
Exclusion Criteria
  • patients with pacemaker replacements were excluded.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
high-grade AVB patients undergoing permanent pacemaker implantationsRight ventricular pacing (RVP)-
high-grade AVB patients undergoing permanent pacemaker implantationsleft bundle branch pacing (LBBP)-
Primary Outcome Measures
NameTimeMethod
composed of all-cause mortality, lead failure and heart failure hospitalization (HFH) during the follow-upsthrough study completion, an average of 2.45 year

composed of all-cause mortality, lead failure and heart failure hospitalization (HFH) during the follow-ups

Lead failurethrough study completion, an average of 2.45 year

reintervention for increased pacing thresholds, lead dislocation or ventricular perforation after the initial implantation procedure

HFHthrough study completion, an average of 2.45 year

HFH was defined as the admission to hospital for \>24 hours with worsening symptoms and signs of heart failure and requiring one or more intravenous diuretics or intravenous inotropic medications

Secondary Outcome Measures
NameTimeMethod
peri-procedure complicationthrough study completion, an average of 2.45 year

included pericardial tamponade and pneumothorax

cardiac deaththrough study completion, an average of 2.45 year

documented arrhythmogenic death, an unexpected presumed pulseles condition with the absence of an obvious noncardiac explanation, or a death due to congestive cardiac failure or structural heart disease

recurrent unexplained syncopethrough study completion, an average of 2.45 year

recurrent unexplained syncope

Trial Locations

Locations (1)

West China Hospital, Sichuan University

🇨🇳

Sichuan, Sichuan, China

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