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The Postoperative S Wave in Lead V5 and/or V6 Predicts Better Clinical Outcomes in Heart Failure Patients With Left Bundle Branch Area Pacing

医学 射血分数 铅(地质) 心脏再同步化治疗 心力衰竭 比例危险模型 心脏病学 内科学 置信区间 左束支阻滞 QRS波群 地貌学 地质学
作者
Kailun Zhu,Chen He,Hao‐Jie Zhu,Chuangshi Wang,Xiaofei Li,Xiaohan Fan
出处
期刊:Pacing and Clinical Electrophysiology [Wiley]
卷期号:48 (10): 1077-1085
标识
DOI:10.1111/pace.70031
摘要

ABSTRACT Background S wave in lead V 5/6 has been reported as a marker indicated for successful left bundle branch (LBB) capture. This study aimed to evaluate the value of the S wave in lead V 5/6 in predicting the long‐term clinical outcomes in heart failure (HF) patients treated with left bundle area pacing (LBBAP). Methods Consecutive HF patients receiving LBBAP were prospectively enrolled and followed at least 2 years. ECG were analyzed to identify the S wave in lead V 5/6 . The composite end point was all‐cause mortality, HF hospitalization, and malignant ventricular arrhythmias. Non‐response to LBBAP delivered cardiac resynchronization therapy (CRT) was defined as left ventricular ejection fraction improvement <5% at 6 months after implantation. Results A total of 57 patients were included with the mean age of 59.90 ± 12.57 years and 39 (68.42%) males. S wave in V 5/6 was observed in 38 patients. During a mean follow up of 29.84 ± 12.51 months, Kaplan–Meier curves showed a 77.8% reduction in risk of composite end point for V 5/6 with S (HR 0.222; 95% CI 0.065, 0.756; log‐rank, p = 0.0069). Multivariate Cox regression analysis revealed that V 5/6 with S was associated with a lower risk of the composite end point by 69.0% (adjusted HR 0.31; 95% CI 0.09, 1.05; p = 0.041). The non‐response rate of LBBAP was 22.58% in V 5/6 with S and 58.82% in V 5/6 without S ( p = 0.012). Conclusion S wave in lead V 5 and/or V 6 after LBBAP predicts better clinical outcomes, and has a better response rate of LBBAP for CRT in HF patients.
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