A Study to Analyze the Feasibility and Effectiveness of Left Bundle Branch Area Pacing Used in Young Children

Objective: This study was performed to investigate the feasibility and effectiveness of left bundle branch area pacing (LBBaP) used in young children. Methods From September 2020 to May 2021, total of thirty-one children (≤ 7 years old) with complete atrioventricular block were included. All patients were intended to receive the operation of LBBaP. The pacing parameters, cardiac function and cardiac synchrony were evaluated during follow-up. Results LBBaP succeeded in twenty-two children (3.3 ± 2.1 years old), with a success rate of 70.9%. LBBaP had failed in nine children, these children received right ventricular septal pacing (RVSP) eventually. The average postoperative QRS duration in patients of LBBaP group was narrower than that of RVSP group: 100.9 ± 9.1 versus 114.2 ± 11.9 ms ( P  = 0.002). The median time of follow-up was 12 (IQR 6–15) months. At last time of follow-up, the capture threshold of ventricular electrode in patients of LBBaP group were significantly lower than that of RVSP group (0.70 ± 0.25 versus 1.39 ± 0.94 V, P  = 0.011). The echo-LVEF in patients of LBBaP group were better than that of RVSP group (66.1 ± 3.3 versus 63.1 ± 2.2%, P  = 0.025). Additionally, the intraventricular and interventricular synchrony parameters in patients of LBBaP group were better than that of RVSP group: the standard deviation of time to peak strain (38.1 ± 5.3 versus 50.3 ± 7.0 ms, P  = 0.000) and the interventricular mechanical delay time (38.4 ± 19.9 versus 65.0 ± 31.1 ms, P  = 0.012) respectively. Conclusion LBBaP could be safely and effectively for young children. Satisfactory pacing parameters, narrow QRS duration and well cardiac synchrony parameters could be obtained.