Related Experiment Video

Updated: Aug 13, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

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Lead Performance and Echocardiographic Outcomes for Delayed Bundle Capture Loss During Conduction System Pacing

Shengjie Wu1, Lan Su1, Yuchao Fang1

  • 1Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Pacing and Clinical Electrophysiology : PACE
|March 18, 2025
PubMed

Insights

Conduction system pacing (CSP) has a low rate of bundle capture loss. Recapturing the bundle significantly improves cardiac function in patients with cardiac resynchronization therapy (CRT) indications.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Conduction system pacing (CSP) mitigates adverse hemodynamic effects of conventional ventricular pacing.
  • Limited data exists on lead performance and echocardiographic outcomes for delayed bundle capture loss during CSP.

Purpose of the Study:

  • Evaluate the incidence of complete bundle capture loss or correction failure during CSP.
  • Assess subsequent clinical outcomes and the impact of lead revision.

Main Methods:

  • Screened patients with successful CSP lead implantation for ventricular pacing or CRT.
  • Identified reasons for complete loss of capture or left bundle branch block (LBBB) correction failure.
  • Analyzed clinical outcomes and echocardiographic data post-intervention.

Main Results:

  • Nine out of 2636 patients experienced complete loss of bundle capture or LBBB correction.
  • Loss attributed to unexplained causes (6), dislodgement (1), surgical damage (1), and malfunction (1).
  • Lead revision in 6 CRT patients improved LVEF from 40.6% to 59.1%; 3 AV block patients without revision had stable function.

Conclusions:

  • Complete capture loss during CSP is infrequent.
  • Recapturing/recorrecting the bundle significantly improves cardiac function in CRT patients.
  • CSP demonstrates favorable lead performance and clinical outcomes.
Abstract

Keywords:
His bundle pacingcapture losslead dislodgementlead extractionleft bundle branch pacingreimplantation

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