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Your search keyword '"Qian, Zhiyong"' showing total 187 results
Start Over Author "Qian, Zhiyong" Publisher elsevier b.v.
187 results on '"Qian, Zhiyong"'

22. Comparisons of long-term clinical outcomes with left bundle branch pacing, left ventricular septal pacing, and biventricular pacing for cardiac resynchronization therapy.

Author

Zhu, Haojie, Qin, Chaotong, Du, Anjie, Wang, Qian, He, Chen, Zou, Fengwei, Li, Xiaofei, Tao, Jin, Wang, Chuangshi, Liu, Zhimin, Xue, Siyuan, Zeng, Jiaxin, Qian, Zhiyong, Wang, Yao, Hou, Xiaofeng, Ellenbogen, Kenneth A., Gold, Michael R., Yao, Yan, Zou, Jiangang, and Fan, Xiaohan

Abstract

Left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP) are referred to as left bundle branch area pacing. This study investigated whether long-term clinical outcomes differ in patients undergoing LBBP, LVSP, and biventricular pacing (BiVP) for cardiac resynchronization therapy (CRT). Consecutive patients with reduced left ventricular ejection fraction (LVEF <50%) undergoing CRT were prospectively enrolled if they underwent successful LBBP, LVSP, or BiVP. The primary composite end point was all-cause mortality or heart failure hospitalization. Secondary end points included all-cause mortality, heart failure hospitalization, and echocardiographic measures of reverse remodeling. A total of 259 patients (68 LBBP, 38 LVSP, and 153 BiVP) were observed for a mean duration of 28.8 ± 15.8 months. LBBP was associated with a significantly reduced risk of the primary end point by 78% compared with both BiVP (7.4% vs 41.2%; adjusted hazard ratio [aHR], 0.22 [0.08–0.57]; P =.002) and LVSP (7.4% vs 47.4%; aHR, 0.22 [0.08–0.63]; P =.004]. The adjusted risk of all-cause mortality was significantly higher in LVSP than in BiVP (31.6% vs 7.2%; aHR, 3.19 [1.38–7.39]; P =.007) but comparable between LBBP and BiVP (2.9% vs 7.2%; aHR, 0.33 [0.07–1.52], P =.155). Propensity score adjustment also obtained similar results. LBBP showed a higher rate of echocardiographic response (ΔLVEF ≥10%: 60.0% vs 36.2% vs 16.1%; P <.001) than BiVP or LVSP. LBBP yielded long-term clinical outcomes superior to those of BiVP and LVSP. The role of LVSP for CRT needs to be reevaluated because of its high mortality risk. [Display omitted] [ABSTRACT FROM AUTHOR]

Published
2024
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34. Early left bundle branch pacing in heart failure with mildly reduced ejection fraction and left bundle branch block.

Author

Zeng, Jiaxin, He, Chen, Zou, Fengwei, Qin, Chaotong, Xue, Siyuan, Zhu, Haojie, Li, Xiaofei, Liu, Zhimin, Wei, Yongyue, Hou, Shuyan, Qian, Zhiyong, Wang, Yao, Hou, Xiaofeng, Yao, Yan, Ellenbogen, Kenneth A., Fan, Xiaohan, and Zou, Jiangang

Abstract

Left bundle branch pacing (LBBP) achieves resynchrony and improves cardiac function in heart failure (HF) patients with reduced ejection fraction (EF) by correcting left bundle branch block (LBBB). Few data on the efficacy of early LBBP in HF with mildly reduced EF (HFmrEF) and LBBB have been reported. The purpose of this study was to explore the efficacy of early LBBP in patients with HFmrEF and LBBB. Consecutive patients with HFmrEF (left ventricular EF [LVEF] 35%–50%) and LBBB were prospectively enrolled to receive LBBP (Early-LBBP group) plus guideline-directed medical therapy (GDMT) or GDMT alone (GDMT group). Study outcomes included changes in LVEF, LV end-diastolic diameter (LVEDD), New York Heart Association (NYHA) functional classification, and N-terminal pro–brain natriuretic peptide (NT-proBNP), and clinical events (HF rehospitalization or syncope). Subgroup analysis compared efficacy of LBBP between patients with LBBB only without comorbidities or late gadolinium enhancement (LGE) (LBBB-Only group) and patients with either comorbidities or LGE (LBBB-Combined group). Fifty-four patients were enrolled and analyzed (37 Early-LBBP group; 15 GDMT group). LBBP achieved greater improvement in LVEF (+14.75% ± 7.37% vs –2.42% ± 2.84%; P <.001), reduction of LVEDD (–7.51 ± 5.40 mm vs –0.87 ± 4.36 mm; P <.001) and NYHA classification (–0.84 ± 0.76 vs –0.13 ± 0.74; P =.004), and similar reduction of NT-proBNP (–408.83 ± 920.29 pg/mL vs –229.05 ± 1579.17 pg/mL; P =.610) at 6 months. Early LBBP showed significantly reduced clinical events (0.0% vs 40.0%; P <.001) after 20.68 ± 13.55 months of follow-up. Subgroup analysis showed patients in the LBBB-Only group benefited more from LBBP with regard to LVEF improvement and LVEDD reduction than the LBBB-Combined group. Early LBBP with GDMT demonstrated greater improvement of cardiac function and reduced clinical events than GDMT alone in patients with HFmrEF and LBBB. [Display omitted] [ABSTRACT FROM AUTHOR]

Published
2023
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49. New criterion to determine left bundle branch capture on the basis of individualized His bundle or right ventricular septal pacing.

Author

Qian, Zhiyong, Xue, Siyuan, Zou, Fengwei, Qin, Chaotong, Wang, Yao, Zhang, Xinwei, Qiu, Yuanhao, Wu, Hongping, Hou, Xiaofeng, and Zou, Jiangang

Abstract

Background: Left bundle branch pacing (LBBP) is an emerging physiological pacing modality. How to differentiate LBBP from left ventricular septal pacing (LVSP) remains challenging.Objective: We aimed to develop a new personalized intraoperative criterion to confirm left bundle branch (LBB) capture in patients with or without heart failure (HF).Methods: Patients were enrolled if 12-lead surface electrocardiograms of LBBP, LVSP, temporary His bundle pacing (HBP), and right ventricular septal pacing (RVSP) were recorded during the procedure, with the leads placed in the basal midseptal region. Left ventricular activation time (LVAT) was measured during different pacing modalities. ΔLVAT1 was defined as the difference in LVAT between HBP and LBBP/LVSP. ΔLVAT2 was estimated by the difference in LVAT between RVSP and LBBP/LVSP. ΔLVAT1% and ΔLVAT2% were calculated as the percent reduction of ΔLVAT1 and ΔLVAT2, respectively.Results: A total of 105 consecutive patients were included, of whom 80 (76.2%) had normal cardiac function (65 LBBP and 15 LVSP) and 25 had HF. Patients with LBBP showed significantly shorter LVAT than did those with LVSP. In patients with normal cardiac function, a cutoff value of ΔLVAT1 > 12.5 ms showed 73.9% sensitivity and 93.3% specificity to confirm LBB capture. In patients with HF, a cutoff value of ΔLVAT1% > 9.8% exhibited great accuracy for LBB capture (sensitivity 92.0%; specificity 92.3%). The optimal value of ΔLVAT2% for differentiating LBBP from LVSP was 21.2%.Conclusion: Temporary HBP and RVSP can serve as references to confirm LBB capture in an individualized fashion in patients with or without HF. [ABSTRACT FROM AUTHOR]

Published
2022
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