Sex Differences in Left Bundle Branch Area Pacing Versus Biventricular Pacing for Cardiac Resynchronization Therapy

被引：2

作者：

Tedrow, Usha B. ^{[1
]}

Miranda-Arboleda, Andres F. ^{[1
]}

Sauer, William H. ^{[1
]}

Duque, Mauricio ^{[2
]}

Koplan, Bruce A. ^{[1
]}

Marin, Jorge E. ^{[3
]}

Aristizabal, Julian M. ^{[3
]}

Nino, Cesar D. ^{[4
]}

Bastidas, Oriana

Martinez, Juan M. ^{[3
]}

Hincapie, Daniela ^{[1
]}

Hoyos, Carolina ^{[1
]}

Matos, Carlos D. ^{[1
]}

Lopez-Cabanillas, Nestor ^{[5
]}

Steiger, Nathaniel A. ^{[1
]}

Tadros, Thomas M. ^{[1
]}

Zei, Paul C. ^{[1
]}

Diaz, Juan C. ^{[2
]}

Romero, Jorge E. ^{[1
]}

机构：

[1] Harvard Med Sch, Brigham & Womens Hosp, Cardiac Arrhythmia Serv, Boston, MA USA

[2] Univ CES Med Sch, Cardiac Arrhythmia & Electrophysiol Serv, Div Cardiol, Clin Las Vegas, Medellin, Colombia

[3] Las Amer Cardiovasc Inst, Dept Med, Cardiac Arrhythmia & Electrophysiol Serv, Div Cardiol, Medellin, Colombia

[4] Clin SOMER, Cardiac Arrhythmia & Electrophysiol Serv, Rionegro, Colombia

[5] Adventist Cardiovasc Inst, Electrophysiol Serv, Buenos Aires, Argentina

来源：

JACC-CLINICAL ELECTROPHYSIOLOGY | 2024年 / 10卷 / 07期

关键词：

biventricular pacing; cardiac resynchronization therapy; heart failure; left bundle branch area pacing; left ventricular ejection fraction; CONDUCTION SYSTEM; OUTCOMES; WOMEN; IMPLANTATION;

D O I：

10.1016/j.jacep.2024.05.011

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Women respond more favorably to biventricular pacing (BIVP) than men. Sex differences in atrioventricular and interventricular conduction have been described in BIVP studies. Left bundle branch area pacing (LBBAP) offers advantages due to direct capture of the conduction system. We hypothesized that men could respond better to LBBAP than BIVP. OBJECTIVES This study aims to describe the sex differences in response to LBBAP vs BIVP as the initial cardiac resynchronization therapy (CRT). METHODS In this multicenter prospective registry, we included patients with left ventricular ejection fraction <= 35% and left bundle branch block or a left ventricular ejection fraction <= 40% with an expected right ventricular pacing exceeding 40% undergoing initial CRT with LBBAP or BIVP. The composite primary outcome was heart failure-related hospitalization and all-cause mortality. The primary safety outcome included all procedure-related complications. RESULTS There was no significant difference in the primary outcome when comparing men and women receiving LBBAP (P = 0.46), whereas the primary outcome was less frequent in women in the BIVP group than men treated with BIVP (P = 0.03). The primary outcome occurred less frequently in men undergoing LBBAP (29.9%) compared to those treated with BIVP (46.5%) (P = 0.004). In women, the incidence of the primary endpoint was 24.14% in the LBBAP group and 36.2% in the BIVP group; however, this difference was not statistically significant (P = 0.23). Complication rates remained consistent across all groups. CONCLUSIONS Men and women undergoing LBBAP for CRT had similar clinical outcomes. Men undergoing LBBAP showed a lower risk of heart failure-related hospitalizations and all-cause mortality compared to men undergoing BIVP, whereas there was no difference between LBBAP and BIVP in women. (JACC Clin Electrophysiol 2024;10:1736-1749) (c) 2024 by the American College of Cardiology Foundation.

引用

页码：1736 / 1749

页数：14

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