Left bundle branch pacing significantly reduced the risk of all-cause mortality and/or heart failure hospitalization by 72% (RR 0.28) compared with left ventricular septal pacing.
Meta-Analysis (n=2,546)
Does left bundle branch pacing improve efficacy and safety compared with left ventricular septal pacing in patients requiring pacing?
LBBP provides superior efficacy compared to LVSP in patients with reduced LVEF and wide QRS, but similar efficacy in those with preserved LVEF and narrow QRS, with comparable safety profiles.
Effect estimate: RR 0.28 (95% CI 0.17-0.48)
p-value: p=<0.001
Background: Although numerous studies have compared the efficacy and safety of left bundle branch pacing (LBBP) and left ventricular (LV) septal pacing (LVSP), the results remain inconclusive. Objective: This meta-analysis aimed to systematically compare the efficacy and safety of LBBP with that of LVSP. Methods: A comprehensive literature search was conducted across PubMed, Europe PMC, and ScienceDirect to identify studies comparing procedural duration, complications, electrophysiological and echocardiographic parameters, and clinical outcomes between LBBP and LVSP. Results: < .001). In patients with preserved LVEF and narrow QRS duration, postpacemaker implantation LVEF and LV end-diastolic diameter and the risk of heart failure hospitalization were comparable between the 2 groups. Furthermore, procedural duration, complications, and pacing parameters (sensing amplitude, capture threshold, and lead impedance) did not significantly differ between the groups. Conclusion: In patients with reduced LVEF and wide QRS duration, LBBP demonstrates superior efficacy compared with LVSP. In contrast, in patients with preserved LVEF and narrow QRS duration, the efficacy of LBBP and LVSP is similar. Both groups exhibit comparable safety profiles and procedural efficiency.
Putra et al. (Wed,) conducted a meta-analysis in Bradycardia and heart failure requiring permanent pacemaker implantation (n=2,546). Left bundle branch pacing (LBBP) vs. Left ventricular septal pacing (LVSP) was evaluated on All-cause mortality and/or heart failure hospitalization (RR 0.28, 95% CI 0.17-0.48, p=<0.001). Left bundle branch pacing significantly reduced the risk of all-cause mortality and/or heart failure hospitalization by 72% (RR 0.28) compared with left ventricular septal pacing.