慢性右心室起搏患者升级为左束支区域起搏后生活质量分析OA北大核心CSTPCD

Objevtive To determine the health-related quality of life(QOL)after left bundle branch area pacing(LBBAP)upgrade in patients after chronic long-term right ventricular pacing(RVP).Methods Patients(enrolled in the Sir Run Run Shaw Hospital from June,2020 to June,2022)referred for pulse generator change or heart failure with long-term RVP of larger than 40％attempted for LBBAP upgrade were included.Cardiovascular health and quality of life were measured by three sacles:36-Item Short-Form health survey(SF-36),Three-level version EQ-5D(EQ-5D-3L)and minnesota living with heart failure(MLHFQ).The datas were compared at baseline,3 months and 12 months after LBBAP.Results Permanent LBBAP upgrade was successful in 23 of twenty-five patients and were followed up for 12 months.After multi-time period statistical analysis,Improvements in QOL parameters including physical functioning(P＜0.001),role-physical(P＜0.001),general health(P＜0.001),vitality(P=0.005),Social role(P=0.006),and Mental health(P=0.002)on the MOS SF-36 Health Survey,Total scores of EQ-5D-3L(P=0.004)and MLHFQ(P＜0.001)were all improved significantly during 12 months,and the improvements were more obvious in 12 months than in 3 months.After 12-month follow up,Parameters of Cardiac function including:N-terminal pro-B-type(Pro-BNP)(P=0.004),left ventricular ejection fraction(LVEF)(P＜0.001)and left ventricular end of systolic volume(LVESV)(P=0.001)were all improvented significantly.Amony all patients,the improvement in QOL was greater in 11 patients(11/23)with pacing-induced cardiomyopathy(PICM)than those(12/23)withnot at 12-month follow-up.Conclusion The health-related QOL can be improved by LBBAP upgrade in patients by long term RVP.LBBAP can reverse electrical synchrony and structure remodeling by chronic RVP,patients with PICM benefit more.