• Yucheng Wu, Yuanyuan Chen, Meng Chen, Qin Chang, Zhixin Jiang, Xiujuan Zhou, and Qijun Shan.
• Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, China.
• Rev Invest Clin. 2020 Dec 2.

BackgroundDifferent from the traditional right ventricular pacing, the left bundle branch area pacing (LBBAP) is accomplished with deeper lead implantation and more attempts. However, myocardial damage is unclear in LBBAP.ObjectiveThe objective of the study was to observe the change of troponin T and explore possible factors associated with greater myocardial damage in LBBAP.MethodsPatients with an indication for pacemaker implantation underwent attempts for LBBAP by transventricular septal method. Levels of troponin T were determined before operation, 12 h and 1 week after the operation. Parameters of intraoperation and follow-up were recorded and analyzed.ResultsIn total, successful LBBAP was achieved in 126 patients. The levels of troponin T increased significantly at 12 h after the operation compared with those before operation (96.45 ± 11.07 [69.06] vs. 16.59 ± 1.84 [11.92] ng/L, p < 0.001), while there were no significant differences between pre- and post-operative levels at 1 week. Correlation and regression analysis showed that only the number of attempts was an independent factor related to the change of troponin T. During 1 year of follow-up, LBBAP was safe and feasible with few complications.ConclusionsMyocardial damage of LBBAP was clinically significant. The number of attempts was an independent factor related to the myocardial damage.

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