Abstract 13984: The Feasibility and Safety of Left Bundle Branch Pacing in Patients With Tricuspid Valve Disease

Background: Although left bundle branch pacing (LBBP) has emerged as a novel physiological pacing strategy, it is still challenging in cases with tricuspid valve disease. Meanwhile, the influence of LBBP lead on tricuspid regurgitation has not been well established in these patients. In the present study, we evaluate the feasibility and safety of LBBP in patients with tricuspid valve disease. Methods: We enrolled 24 patients with tricuspid valve disease who received LBBP procedure in Zhongshan Hospital, Fudan University, between January 2018 and July 2020. Regular follow-ups were conducted (at 1 and 12 months), and the echocardiography data of the patients were collected and analyzed. Results: One postoperative lead dislodgements (1/24, 4.2%) occurred during the follow-up. Mean fluoroscopy time of placing LBBP lead was 19.75±08.23 minutes. Mean follow-up period was 9.64±4.17 months. Pacing parameters were stable during follow-up in all cases. The severity of tricuspid regurgitation(TR) (no 0, slight 1. mild 2, medium 3 and severe 4) under echocardiography were measured and compared at baseline and 1-year follow-up post-procedure. No significant aggravation occurred (2.88±1.57 vs 3.00±1.44, P=0.13). Left ventricular ejection fraction remain stable from baseline to 1-year follow-up(56.27±11.73% vs 59.30±8.17%, P=0.09). Conclusion: LBBP was feasible and safety in patients with tricuspid valve disease though these cases were always challenging such as longer fluoroscopy time, more technocratic requirements, higher rates of failure and procedure-related complications than HBP. Lead parameters were stable during follow-up. No significant aggravation of TR was found.