Key result
Spontaneous baseline ECG template beats may identify patients likely to respond favorably to LBAP.
Why the study?
Electrocardiographic analysis rarely provides specific clues to identify patients who may benefit most from left bundle area pacing.
A spontaneous 'template beat' on baseline ECG is proposed as a novel marker to identify patients likely to respond favorably to left bundle area pacing.
May aid ECG-based selection for left bundle area pacing; hypothesis-generating and should not yet change practice.
Recent evidence suggests that left bundle area pacing (LBAP) is non-inferior to conventional cardiac resynchronization therapy (CRT) using biventricular pacing (BVP). In addition, LBAP directly recruits the native conduction system, thereby addressing several procedural limitations inherent to BVP. Despite these advantages, electrocardiographic (ECG) analysis rarely provides specific clues to identify patients who may benefit most from LBAP. We report a case in which a spontaneous “template beat” or “left bundle capture beat” was observed on the baseline ECG and propose this finding as a potential novel marker for identifying patients likely to respond favourably to this therapy.
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Madapati et al. (2026) studied this question. A spontaneous 'template beat' on a baseline ECG may serve as a novel marker to identify patients likely to respond favorably to left bundle area pacing.
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