Knowing that there is going to be significant PR prolongation with RA pacing, should a LBBA pacing lead be recommended in patients with a PPM indication and a significant first degree AV block (>250msecs) especially if the patient has a borderline LVEF (~45-55%) to prevent diastolic MR-pacemaker syndrome ?
1 Answers
Mednet Member
Cardiology · Heart And Vascular Center Of Arizona
Yes, this would certainly be reasonable, but less likely required. There are other considerations with LBAP, such as extended procedure time and lack of specific reimbursement for this extra time. If the patient is already tolerating this significant PR, it may not be worth the LBAP if it turns out ...