Left bundle branch pacing versus left ventricular septal pacing as a primary procedural endpoint during left bundle branch area pacing: Evaluation of two different implant strategies

Introduction Implant procedure features and clinical implications of left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP) have not been yet fully described. We sought to compare two different left bundle branch area pacing (LBBAP) implant strategies: the first one accepting LVS...

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Bibliographic Details
Published in:Journal of cardiovascular electrophysiology 2024-01, Vol.35 (1), p.120-129
Main Authors: Cano, Óscar, Jover, Pablo, Ayala, Hebert D., Navarrete‐Navarro, Javier, Osca, Joaquín, Izquierdo, Maite, Navarro, Josep, Martínez‐Dolz, Luis
Format: Article
Language:English
Subjects:
Bundle of His
Bundle-Branch Block - diagnosis
Bundle-Branch Block - therapy
Cardiac Pacing, Artificial - methods
Complications
conduction system pacing
Electrocardiography - methods
Heart diseases
Humans
left bundle branch pacing
left ventricular septal pacing
Patients
Stroke Volume
Ventricle
Ventricular Function, Left
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Summary:Introduction Implant procedure features and clinical implications of left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP) have not been yet fully described. We sought to compare two different left bundle branch area pacing (LBBAP) implant strategies: the first one accepting LVSP as a procedural endpoint and the second one aiming at achieving LBBP in every patient in spite of evidence of previous LVSP criteria. Methods LVSP was accepted as a procedural endpoint in 162 consecutive patients (LVSP strategy group). In a second phase, LBBP was attempted in every patient in spite of achieving previous LVSP criteria (n = 161, LBBP strategy group). Baseline patient characteristics, implant procedure, and follow‐up data were compared. Results The final capture pattern was LBBP in 71.4% and LVSP in 24.2% in the LBBP strategy group compared to 42.7% and 50%, respectively, in the LVSP strategy group. One hundred and eighty‐four patients (57%) had proven LBB capture criteria with a significantly shorter paced QRS duration than the 120 patients (37%) with LVSP criteria (115 ± 9 vs. 121 ± 13 ms, p 
ISSN:1045-3873
1540-8167
DOI:10.1111/jce.16128