Why the study?
Patients with ATTR-CA requiring permanent pacing often have preserved ejection fraction without indications for CRT, making LBBAP a potential option to maximise physiological activation.
Does left bundle branch area pacing (LBBAP) achieve successful capture in patients with cardiac amyloidosis requiring permanent pacemaker implantation?
Does left bundle branch area pacing (LBBAP) achieve successful capture in patients with cardiac amyloidosis requiring permanent pacemaker implantation?
Left bundle branch area pacing using lumenless leads is a feasible option for physiological ventricular activation in patients with cardiac amyloidosis requiring permanent pacing.
Answers are grounded in this paper and cite their sources.
Supports LBBAP feasibility in cardiac amyloidosis; hypothesis-generating and requires prospective validation.
Transthyretin Cardiac amyloidosis (ATTR-CA) is an increasingly recognised cause of heart failure in our elderly patients with preserved ejection fraction. Patients with ATTR-CA who require permanent pacemaker implantation often have preserved ejection fraction and do not meet the clinical indication for cardiac resynchronization therapy (CRT). In these patients, left bundle branch area pacing (LBBAP) can be a reasonable option to maximise physiological activation of the left ventricle. We describe a series of three patients with cardiac amyloidosis who have undergone LBBAP with the use of lumenless leads and successful capture of the myocardium and left bundle branch region.
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Mehta et al. (2025) studied this question.
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