Abstract
Objective: This study aimed to investigate the relationship
between the location of implantation of the Left Bundle Branch Area
Pacing (LBBAP) electrode and the coronary artery and to assess the
safety of LBBAP surgery. Methods: Patients who underwent the
LBBAP procedure and coronary angiography (CAG) at the Second Affiliated
Hospital of Nanchang University between January 1, 2019 to October 1,
2020 were included. We read the patient’s LBBAP and CAG imaging data and
used the nine-partition method to measure the vertical distance from the
tip of the pacing electrode to each coronary artery in multiple
projection positions during the ventricular systolic period. Changes in
the ST-T segment in the electrocardiogram, serum troponin and myocardial
enzyme profiles were observed before and after the LBBAP surgery.
Results: Overall, 50 patients were evaluated. The average
vertical distances from the electrode tip to the left anterior
descending branch (LAD), right posterior coronal descending branch (PD),
left posterior ventricular branch (PL) were 19.69±8.72 mm, 26.09±8.02
mm, and 21.11±7.86 mm, respectively. The minimum were 5.28 mm, 9.51 mm
and 8.69 mm, respectively. CAG in all patients showed no significant
injury to the ventricular septal branch. And there were no elevated
serum troponin or cardiac enzyme profiles. Conclusions: This
study suggested that the coronary arteries were safest when the LBBAP
electrodes were placed within a rectangle formed by the PM, M, PI, and
MI center points. The PM was the ideal position to implant the LBBAP
electrodes, which had a low risk of coronary vascular injury.