Synapse
⌘+K
Synapse
PulseExploreJournal ClubResearchersJournals
Instagram
HomeJournal ClubExplore
May 1, 2025Journal of Innovations in Cardiac Rhythm ManagementOpen Access

Learning Curve for Left Bundle Branch Area Pacing Lead Implantation

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Does operator experience (>10 implants) improve procedural metrics and outcomes in Left Bundle Branch Area Pacing (LBBAP) lead implantation?

Population

Patients undergoing Left Bundle Branch Area Pacing (LBBAP) lead implantation

Comparison

LBBAP lead implantation by operators after their… vs LBBAP lead implantation during the operators'…

Design

Cohort

Key result

Left bundle branch area pacing procedural success (LVAT ≤ 80 ms) was significantly lower for inexperienced operators (≤10 cases) compared to experienced operators (56.9% vs 72.4%, P = .04).

Authors

MCMaci ClarkHZHannah ZerrBOBen Ose

Discussion

Loading...

Member takes

Overview

May warrant proctoring for initial LBBAP cases; leaves open optimal training thresholds.

Study Design

Type

Cohort (n=288)

Multicenter

No

Structured PICO

Does operator experience (>10 implants) improve procedural metrics and outcomes in Left Bundle Branch Area Pacing (LBBAP) lead implantation?

P
Population
Patients undergoing Left Bundle Branch Area Pacing (LBBAP) lead implantation
I
Intervention
LBBAP lead implantation by operators after their first 10 implants
C
Comparator
LBBAP lead implantation during the operators' first 10 implants
O
Outcome
Fluoroscopy use, number of attempts at LBBAP, and achievement of LVAT ≤ 80 mssurrogate

Main Result

Absolute Event Rate: 56.9% vs 72.4%

p-value: p=0.04

The learning curve for LBBAP lead implantation suggests that procedural proficiency, including reduced fluoroscopy and improved LVAT, is achieved after approximately 10 cases.

Limitations

  • Retrospective analysis introducing possibilities for biases
  • Single tertiary academic center limits generalizability
  • Predominantly elderly, Caucasian patient population
  • Changes in implantation techniques and technology over the 3-year study period
  • Operators did not receive formal training for LBBAP

Cite This Study

Clark et al. (2025) conducted a cohort in Patients undergoing pacemaker implantation requiring left bundle branch area pacing (n=288). LBBAP implantation by inexperienced operators (≤10 prior cases) vs. LBBAP implantation by experienced operators (>10 prior cases) was evaluated on Procedural success defined as left ventricular activation time (LVAT) ≤ 80 ms (p=0.04). Left bundle branch area pacing procedural success (LVAT ≤ 80 ms) was significantly lower for inexperienced operators (≤10 cases) compared to experienced operators (56.9% vs 72.4%, P = .04).

synapsesocial.com/papers/6a153f2037103a43379f704dhttps://doi.org/10.19102/icrm.2025.16055
View Full Paper
Ask AI
Bookmark
Share