Does left bundle branch pacing improve safety and efficacy compared to His bundle pacing in patients with atrial fibrillation and heart failure after AVJ ablation?
In patients with atrial fibrillation and heart failure post-AVJ ablation, left bundle branch pacing offers higher implant success, better pacing parameters, and fewer complications compared to His bundle pacing.
BACKGROUND: Left bundle branch pacing (LBBP) has emerged as a promising pacing modality to preserve physiological left ventricular activation; however, prospective data evaluating its long-term safety and efficacy in pacemaker-dependent patients following atrioventricular junction (AVJ) ablation are lacking. This study aimed to examine the feasibility, safety, and efficacy of LBBP in patients with atrial fibrillation and heart failure (HF) after AVJ ablation and compare LBBP with His bundle pacing (HBP) through a propensity score (PS) matching analysis. METHODS: We prospectively enrolled patients with atrial fibrillation and HF referred for AVJ ablation and LBBP between July 2017 and December 2019. The control group was patients selected from HBP implants performed from 2012 to 2019 using PS matching with a 1:1 ratio. RESULTS: <0.05). CONCLUSIONS: LBBP is feasible, safe, and effective in patients with atrial fibrillation and HF post-AVJ ablation and has similar clinical benefits, a higher implant success rate, better pacing parameters, and fewer complications compared with HBP.
Cai et al. (Tue,) studied this question.