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Related Experiment Video

Updated: Jun 24, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Closed loop stimulation in left bundle branch area pacing.

Gabriele Dell'Era1, Chiara Ghiglieno1, Federica De Vecchi1

  • 1Clinica Cardiologica, Dipartimento Toraco-Cardio-Vascolare, Ospedale Maggiore della Carità, Novara, Italy.

Pacing and Clinical Electrophysiology : PACE
|June 8, 2024
PubMed
Summary
This summary is machine-generated.

Closed Loop Stimulation (CLS) effectively adjusts heart rate (HR) with left bundle branch area pacing (LBBAP), showing similar HR distribution and mean HR compared to DDD pacing. This indicates CLS is a viable rate-responsive option for LBBAP.

Keywords:
closed loop stimulationheart rateleft bundle branch area pacingpacemakerrate‐responsive

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Closed Loop Stimulation (CLS) is a rate-responsive pacing algorithm using intracardiac impedance.
  • Its efficacy in conduction system pacing, specifically left bundle branch area pacing (LBBAP), remains uninvestigated.
  • Chronotropic incompetence necessitates rate-responsive pacing solutions.

Purpose of the Study:

  • To evaluate the rate-responsive performance of CLS in patients undergoing LBBAP.
  • To assess if CLS with LBBAP can achieve appropriate heart rate (HR) distribution in daily life.
  • To compare CLS-LBBAP with conventional DDD pacing in LBBAP patients.

Main Methods:

  • Retrospective study comparing 24 patients with CLS-LBBAP and 19 patients with DDD-LBBAP.
  • Data collected via device interrogation with a minimum 30-day follow-up.
  • Analysis of cumulative HR distribution and mean HR.

Main Results:

  • CLS-LBBAP showed a higher percentage of atrial pacing compared to DDD-LBBAP (58% vs. 13%, p=0.001).
  • CLS-paced beats were observed across all heart rate frequency bins.
  • No significant difference in beat distribution (p=0.643) or mean HR (72 bpm vs. 73 bpm, p=0.615) between groups.

Conclusions:

  • CLS effectively modulates pacing rates in LBBAP across a wide frequency range.
  • The lead position in LBBAP does not negatively impact CLS performance.
  • CLS is a suitable rate-responsive algorithm for LBBAP, offering comparable HR control to DDD pacing.