Related Experiment Video
Updated: Jul 12, 2026
12:45
Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Comparison of Pacing Lead Design on Left Bundle Branch Pacing Outcomes: LEAD-LBBP Randomized Clinical Trial
Eugene S J Tan1, Rodney Soh2, Jie-Ying Lee3
1Department of Cardiology, National University Heart Centre, Singapore; Yong Loo Lin School of Medicine, National University Singapore, Singapore.
JACC. Clinical Electrophysiology
|July 10, 2026
Summary
Stylet-driven leads (SDLs) in left bundle branch pacing (LBBP) increase loss of capture and lead damage compared to lumenless leads (LLLs). Lumenless leads offer better outcomes for LBBP procedures.
Area of Science:
- Cardiology
- Medical Devices
- Electrophysiology
Background:
- Stylet-driven leads (SDLs) are linked to higher rates of left bundle branch capture loss (LLC) and lead damage during left bundle branch pacing (LBBP).
- Choosing the right pacing lead is crucial for successful LBBP implantation and long-term outcomes.
Purpose of the Study:
- To compare the incidence of LLC and other pacing outcomes between lumenless leads (LLLs) and SDLs in LBBP recipients.
- To evaluate the safety and efficacy of different lead designs in LBBP.
Main Methods:
- The LEAD-LBBP randomized clinical trial compared LLLs and SDLs in LBBP recipients.
- A 1:1 block randomization was used, with LLC as the primary endpoint.
- Secondary endpoints included acute LBBP success, lead damage, pacing parameters, complications, and clinical outcomes.
Main Results:
- LLCs occurred more frequently with SDLs (22%) versus LLLs (10%) at 12 months, with a 2.7 times increased risk with SDLs.
- SDLs were associated with lower acute LBBP success (85% vs 96%) and higher acute lead damage (10% vs 3%).
- Pacing parameters, overall complications, and clinical outcomes were similar between the groups.
Conclusions:
- SDLs lead to a higher incidence of LLC, lower acute procedural success, and increased lead damage during LBBP implantation compared to LLLs.
- These findings suggest LLLs may be a preferred choice for LBBP procedures to improve outcomes and reduce complications.
