Initial Experience, Safety, and Feasibility of Left Bundle Branch Area Pacing: A Multicenter Prospective Study
Santosh K Padala1, Vivak M Master1, Maria Terricabras2
1Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia, USA.
JACC. Clinical Electrophysiology
|December 28, 2020
Summary
Left bundle branch area pacing (LBBAP) is a safe and feasible alternative to His bundle pacing, offering physiological pacing with high success rates. Further randomized studies are recommended to confirm its clinical outcomes.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Device Technology
Background:
- Limited data exists on left bundle branch area pacing (LBBAP), a conduction system pacing technique.
- LBBAP may overcome technical and electrophysiological challenges associated with His bundle pacing.
Purpose of the Study:
- To evaluate the safety and feasibility of left bundle branch area pacing (LBBAP).
- To assess LBBAP as a method for physiological pacing.
Main Methods:
- LBBAP was performed in 341 patients using a specialized delivery sheath for lead implantation.
- Implant success rates, complications, and electrophysiological parameters were assessed over a 12-month follow-up period.
Main Results:
- LBBAP achieved an 89% success rate in 341 patients.
- Mean paced QRS duration was significantly narrowed compared to baseline, particularly in patients with infra-Hisian disease.
- Low complication rates were observed, primarily lead dislodgements.
Conclusions:
- Left bundle branch area pacing (LBBAP) is a safe, feasible, and reliable alternative to His bundle pacing.
- LBBAP facilitates physiological pacing with promising results.
- Randomized controlled trials are necessary to validate LBBAP's safety, feasibility, and clinical outcomes.
