Advertisement

Is left bundle area pacing the future of pacing for bradycardia?

Published:October 05, 2021DOI:https://doi.org/10.1016/j.hrthm.2021.09.039
      Conduction system pacing is rapidly growing in popularity but still represents a small minority of pacing systems implanted in the United States. His bundle pacing (HBP) was the first approach developed. However, HBP is a challenging procedure that is often associated with low-sensed R waves and high pacing thresholds.
      • Teigeler T.
      • Kolominsky J.
      • Vo C.
      • et al.
      Intermediate-term performance and safety of His-bundle pacing leads: a single-center experience.
      Moreover, exit block can develop over time, so there was reluctance earlier to use this approach in patients with heart block. Left bundle branch area pacing (LBBAP) has emerged as a promising alternative to HBP that circumvents many of the disadvantages of HBP. Prior studies showed that LBBAP is a safe, feasible, and reliable approach to conduction system pacing.
      • Liu X.
      • Niu H.
      • Gu M.
      • et al.
      Contrast-enhanced image-guided lead deployment for left bundle branch pacing.
      • Li Y.
      • Chen K.
      • Dai Y.
      • et al.
      Left bundle branch pacing for symptomatic bradycardia: implant success rate, safety, and pacing characteristics.
      • Padala S.K.
      • Ellenbogen K.A.
      Left bundle branch pacing is the best approach to physiological pacing.
      To read this article in full you will need to make a payment
      Subscribe to Heart Rhythm
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Teigeler T.
        • Kolominsky J.
        • Vo C.
        • et al.
        Intermediate-term performance and safety of His-bundle pacing leads: a single-center experience.
        Heart Rhythm. 2021; 18: 743-749
        • Liu X.
        • Niu H.
        • Gu M.
        • et al.
        Contrast-enhanced image-guided lead deployment for left bundle branch pacing.
        Heart Rhythm. 2021; 18: 1318-1325
        • Li Y.
        • Chen K.
        • Dai Y.
        • et al.
        Left bundle branch pacing for symptomatic bradycardia: implant success rate, safety, and pacing characteristics.
        Heart Rhythm. 2019; 16: 1758-1765
        • Padala S.K.
        • Ellenbogen K.A.
        Left bundle branch pacing is the best approach to physiological pacing.
        Heart Rhythm O2. 2020; 1: 59-67
        • Sweeney M.O.
        • Hellkamp A.S.
        • Ellenbogen K.A.
        • et al.
        Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction.
        Circulation. 2003; 107: 2932-2937
        • Kiehl E.L.
        • Makki T.
        • Kumar R.
        • et al.
        Incidence and predictors of right ventricular pacing-induced cardiomyopathy in patients with complete atrioventricular block and preserved left ventricular systolic function.
        Heart Rhythm. 2016; 13: 2272-2278
        • Sharma P.S.
        • Patel N.R.
        • Ravi V.
        • et al.
        Clinical outcomes of left bundle branch area pacing compared to right ventricular pacing: results from the Geisinger-Rush Conduction System Pacing Registry.
        Heart Rhythm. 2021; (accessed Octoer 17, 2021)https://doi.org/10.1016/j.hrthm.2021.08.033
        • Glikson M.
        • Nielsen J.C.
        • Kronborg M.B.
        • et al.
        2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy.
        Eur Heart J. 2021; 42: 3427-3520

      Linked Article