Related Experiment Video

Updated: Aug 21, 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

Published on: December 11, 2017

Left Bundle Branch Area Pacing in Congenital Heart Disease: Current Evidence, Challenges, and Future Directions

Reisuke Yoshizawa1

  • 1Division of Cardiology, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan.

Pacing and Clinical Electrophysiology : PACE
|August 20, 2026
PubMed

Insights

Left bundle branch area pacing (LBBAP) offers a promising alternative for congenital heart disease (CHD) patients. This review synthesizes evidence on LBBAP in CHD, highlighting its potential and research needs.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Congenital Heart Disease

Background:

  • Right ventricular apical pacing is standard for congenital heart disease (CHD), but Left bundle branch area pacing (LBBAP) is an emerging alternative.
  • Unique anatomical and physiological challenges in CHD patients make LBBAP application underexplored.

Purpose of the Study:

  • To synthesize current evidence on LBBAP in CHD patients.
  • To provide a framework for patient selection, lead choice, and procedural planning.
  • To identify research priorities for LBBAP in CHD.

Main Methods:

  • Review of current evidence on LBBAP in CHD.
  • Analysis of anatomical considerations, lead selection, technical modifications, and clinical outcomes.
  • Inclusion of data from observational series and meta-analyses.

Main Results:

  • Favorable anatomy for LBBAP in congenitally corrected transposition of the great arteries (CCTGA) with high success rates (86%-100%).
  • Conduction system pacing (CSP) showed superior QRS narrowing compared to conventional CRT (35 vs. 14 ms).
  • Lumenless and stylet-driven leads show comparable success but different safety profiles.

Conclusions:

  • LBBAP is a viable option in CHD, particularly in CCTGA.
  • Lead selection requires careful consideration of safety profiles in CHD patients.
  • Further research is needed to establish LBBAP's role and optimize its application in CHD.

Keywords:
cardiac resynchronization therapyconduction system pacingcongenital heart diseasecongenitally corrected transpositionleft bundle branch area pacinglumenless leadsstylet‐driven leadssystemic right ventricle

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