Consecutive Experience with Left Bundle Branch Area Pacing in a High-Volume Australian Centre

Area of Science:

• Cardiology
• Electrophysiology
• Medical Device Technology

Background:

• Left-bundle branch area pacing (LBBAP) is an emerging conduction system pacing technique.
• Australian data on LBBAP safety and efficacy is limited.
• This study evaluates LBBAP in a high-volume Australian cohort.

Purpose of the Study:

• To assess the learning curve for LBBAP.
• To evaluate the medium-term safety and lead performance of LBBAP.
• To analyze procedural characteristics and outcomes in an Australian setting.

Main Methods:

• Retrospective cohort study of 200 consecutive LBBAP procedures.
• Procedures performed by a single operator between January 2019 and May 2020.
• Utilized left subclavian access with specific pacing lead and sheath; success defined by capture.

Main Results:

• Acute procedural success rate was 91.5%.
• Significant reduction in QRS duration (134 ms to 114 ms, p<0.001).
• No LBBAP-specific complications; reduced procedural time and X-ray dose over study period.

Conclusions:

• LBBAP demonstrates safety and efficacy for pacing.
• Significant QRS narrowing observed post-implantation.
• An initial learning curve associated with LBBAP was identified.