Why the study?
Traditional right ventricular apical pacing causes dyssynchrony, while His bundle pacing is technically challenging and prone to follow-up issues, making left bundle branch pacing an emerging alternative.
Left bundle branch pacing is highlighted as an effective physiological pacing alternative to His bundle pacing, offering stable pacing thresholds and lead stability.
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Supports LBBP where His pacing is challenging; leaves open need for randomized comparisons.
Cardiac pacing is the only effective therapy for patients with symptomatic bradyarrhythmia. Traditional right ventricular apical pacing causes electrical and mechanical dyssynchrony resulting in left ventricular dysfunction, recurrent heart failure, and atrial arrhythmias. Physiological pacing activates the normal cardiac conduction, thereby providing synchronized contraction of ventricles. Though His bundle pacing (HBP) acts as an ideal physiological pacing modality, it is technically challenging and associated with troubleshooting issues during follow-up. Left bundle branch pacing (LBBP) has been suggested as an effective alternative to overcome the limitations of HBP as it provides low and stable pacing threshold, lead stability, and correction of distal conduction system disease. This paper will focus on the implantation technique, troubleshooting, clinical implications, and a review of published literature of LBBP.
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Ponnusamy et al. (2020) studied this question.
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