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

Sudipta Mondal1, Nadeem Afroz Muslim1

  • 1Department of Cardiology The Mission Hospital Durgapur West Bengal India.

Journal of Arrhythmia
|February 9, 2026
PubMed
Summary
This summary is machine-generated.

This case study explains the double transition sign in bipolar threshold testing after conduction system pacing. It details the electrophysiologic parameters crucial for successful left bundle branch area pacing.

Keywords:
LBBAPdouble transitionleft bundle branch area pacingselective capture

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Conduction system pacing (CSP) is an alternative to traditional right ventricular pacing.
  • The double transition sign is an observed phenomenon during electrophysiologic testing.
  • Understanding pacing parameters is vital for optimizing device therapy.

Purpose of the Study:

  • To differentiate the double transition sign observed during bipolar threshold testing in CSP.
  • To elucidate the electrophysiologic parameters associated with successful left bundle branch capture.
  • To provide insights into the interpretation of pacing signals in advanced cardiac pacing techniques.

Main Methods:

  • Case report detailing a patient undergoing bipolar threshold testing.
  • Analysis of electrophysiologic recordings during conduction system pacing.
  • Evaluation of pacing parameters including output, pulse width, and lead impedance.

Main Results:

  • The study identifies key electrophysiologic characteristics differentiating the double transition sign.
  • Successful left bundle capture is associated with specific pacing parameters and signal morphologies.
  • Differential diagnosis of the double transition sign is presented in the context of CSP.

Conclusions:

  • The double transition sign can be reliably diagnosed and understood within the context of CSP.
  • Specific electrophysiologic parameters are indicative of successful left bundle capture, guiding procedural success.
  • This case contributes to the understanding and application of advanced pacing techniques for improved patient outcomes.