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Related Concept Videos

Electrocardiogram Fundamentals01:28

Electrocardiogram Fundamentals

542
Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
542

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Related Experiment Video

Updated: Jun 12, 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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Learning Curve for Left Bundle Branch Area Pacing Lead Implantation.

Maci Clark1, Hannah Zerr1, Ben Ose1

  • 1The University of Kansas School of Medicine, Kansas City, KS, USA.

The Journal of Innovations in Cardiac Rhythm Management
|June 9, 2025
PubMed
Summary

New operators experienced a learning curve with left bundle branch area pacing (LBBAP), requiring more fluoroscopy and attempts. However, outcomes improved with experience, showing successful LBBAP implantation is achievable.

Keywords:
Complicationsconduction system pacinglearning curveleft bundle branch area pacingoperator experience

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Device Technology

Background:

  • Left bundle branch area pacing (LBBAP) is an emerging technique for cardiac pacing.
  • Understanding the learning curve for LBBAP implantation is crucial for widespread adoption and training.

Purpose of the Study:

  • To analyze the learning curve associated with initial Left Bundle Branch Area Pacing (LBBAP) implantation.
  • To compare procedural success and adverse events between operators with limited (<10) versus extensive (>10) LBBAP experience.

Main Methods:

  • Retrospective analysis of 288 adult patients undergoing LBBAP from 2020-2023.
  • Comparison of operators with ≤10 (LBBAPinexp) vs. >10 (LBBAPexp) implant attempts.
  • Successful LBBAP defined as left ventricular activation time (LVAT) ≤80 ms.

Main Results:

  • Less frequent successful LBBAP (LVAT ≤80 ms) in LBBAPinexp vs. LBBAPexp (56.9% vs. 72.4%, P=.04).
  • Longer fluoroscopy times (12.6 vs. 8.2 min, P<.0001) and more attempts (2.0 vs. 2.9, P=.03) in LBBAPinexp.
  • No significant difference in paced QRS duration, operator-identified success, or device-related adverse events.

Conclusions:

  • Operators demonstrate a learning curve for LBBAP, with initial implants requiring more fluoroscopy and attempts.
  • Achieving optimal LBBAP outcomes (LVAT ≤80 ms) improves with operator experience.
  • Despite the learning curve, LBBAP can be safely adopted with comparable adverse event rates.