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Updated: Aug 5, 2026
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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
Continuous Pacing Recordings Reveal Distinct Right Ventricular Activation Patterns in Left Bundle Branch Area Pacing
Lishan Lin1, Weilin Chen1, Longfu Jiang2
1School of Medicine, Ningbo University, Ningbo, Zhejiang, China.
Pacing and Clinical Electrophysiology : PACE
|July 29, 2026
Summary
Selective left bundle branch pacing (s-LBBP) generally shows longer right ventricular activation times. However, some patients experience shortened activation with s-LBBP compared to left ventricular septal pacing.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Pacing
Background:
- Left bundle branch area pacing (LBBAP) is a physiological pacing method.
- Right ventricular (RV) activation patterns under different LBBAP modalities require further characterization.
Purpose of the Study:
- To investigate RV activation sequences across three LBBAP modalities: left ventricular septal pacing (LVSP), non-selective left bundle branch pacing (ns-LBBP), and selective left bundle branch pacing (s-LBBP).
Main Methods:
- Analyzed RV activation pathways in 250 patients with confirmed s-LBBP.
- Utilized R-wave peak time (RWPT) in leads V1 and V6 to assess activation.
- Compared RWPT changes under varying output voltages across pacing modalities.
Main Results:
- In the V1 RWPT shortening group, LVSP had the longest RWPT; ns-LBBP and s-LBBP showed no significant difference.
- In the V1 RWPT prolongation group, s-LBBP demonstrated significantly prolonged V1 RWPT.
- V6 RWPT was longest in LVSP, with no significant difference between ns-LBBP and s-LBBP.
Conclusions:
- RV activation time is typically similar between LVSP and ns-LBBP.
- S-LBBP generally results in the longest RV activation time.
- A subset of patients (~30%) exhibited shortened RV activation with s-LBBP compared to LVSP.
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