The quality of life of patients with pacemaker-induced cardiomyopathy after they upgrade to left bundle branch pacing

Objective: To investigate the changes in the cardiac function and quality of life of patients with pacemaker-induced cardiomyopathy (PICM) after they upgrade to left bundle branch pacing (LBBP). Methods: Ten patients with PICM who upgraded to LBBP were recruited as the study cohort. The LBBP upgrade operations were all performed by the same cardiac intervention expert. The cardiac function index changes, including the left ventricular end-diastolic diameters, the cardiothoracic ratios, the left ventricular ejection fractions, the N-terminal brain natriuretic peptide levels, the 6 min walking test distances, and the quality of life changes, including the SF-36 scores, the European Five-Dimensional Health Scale (EQ-5D-3L) scores, and the Minnesota Heart failure Quality of Life Scale (MLHFQ) scores before and after the LBBP operations were analyzed. The incidences of adverse events during the postoperative follow-up were analyzed. Results: The ten patients were successfully upgraded to LBBP. Compared with before the operation, the left ventricular end-diastolic diameter levels and the cardiothoracic ratios decreased significantly, but the left ventricular ejection fractions and the 6 min walking test distances increased (P<0.05 or P<0.01). The SF-36 and EQ-5D-3L scores increased gradually, but the MLHFQ scores decreased gradually before the operations and at one month and 12 months after the operations. The physical functioning (PF), role-physical (RP), general health (GH), vitality (VT), and the social role (SR) scores of the SF-36 scale, the TTO index and the visual analog scale (VAS) of the EQ-5D-3L scale scores, and the MLHFQ scores at 12 months after the operations were significantly different from the scores before the operations (all P<0.05). In terms of safety, there were no adverse events such as pacemaker electrode dislocation or interventricular septal perforation during the postoperative follow-up. Conclusion: Upgrading to LBBP can effectively improve cardiac function and the quality of life in patients with PICM, and the operation is safe.