Left Bundle Branch Area Pacing: Implant Technique, Definitions, Outcomes, and Complications

Curr Cardiol Rep. 2021 Oct 1;23(11):155. doi: 10.1007/s11886-021-01585-1.

Abstract

Purpose of review: Conduction system pacing (CSP) has emerged during the last few years as the cornerstone of physiological pacing. Two different CSP modalities have been described so far: His bundle pacing (HBP) and left bundle branch area pacing (LBBAP). This review will be focused on the description of LBBAP technique, definitions, outcomes, and complications.

Recent findings: Large observational studies have demonstrated the safety and feasibility of LBBAP in different scenarios. LBBAP has been associated with excellent pacing electrical parameters (pacing threshold and R wave sensing) and low complication rates including lead revision < 1%. In patients with cardiac resynchronization therapy (CRT) indication, LBBAP has shown significant improvement of functional class and left ventricular ejection fraction during short-term follow-up. LBBAP is a relatively new CSP modality showing excellent results for patients with conventional bradycardia pacing indications and promising expectations about its potential role for CRT.

Keywords: Conduction system pacing; His bundle pacing; Left bundle branch pacing.

Publication types

  • Review

MeSH terms

  • Bundle of His*
  • Electrocardiography
  • Humans
  • Stroke Volume
  • Treatment Outcome
  • Ventricular Function, Left*