Left bundle branch pacing is described as a promising alternative to His bundle pacing for physiological pacing.
Physiological pacing has witnessed a rapid growth in the last decade. His bundle pacing (HBP) provides electrical and mechanical synchrony but may be limited by high pacing thresholds and higher need for lead revisions.1 Left bundle branch pacing (LBBP) has recently been shown to be a promising alternative to HBP. Several criteria for successful left bundle capture have been proposed2 but need to be validated. LBBP involves advancing the lead deep into the septum by rapid rotations. The goal is to place the lead adjacent to the left bundle branch in the left ventricular (LV) subendocardial region without perforation into the LV cavity.
Ponnusamy et al. (2020) studied this question.