Key result
Aiming for LBBP is linked to ~141% more acute septal perforations versus accepting LVSP.
Why the study?
Implant procedure features and clinical implications of LBBP and LVSP had not been fully described.
Does a left bundle branch pacing strategy improve procedural outcomes and LVEF compared to a left ventricular septal pacing strategy in patients undergoing left bundle branch area pacing?
Cohort (n=323)
Does a left bundle branch pacing strategy improve procedural outcomes and LVEF compared to a left ventricular septal pacing strategy in patients undergoing left bundle branch area pacing?
Absolute Event Rate: 11.8% vs 4.9%
p-value: p=0.026
Aiming for left bundle branch pacing rather than accepting left ventricular septal pacing increases the risk of acute septal perforation without providing additional LVEF improvement in patients with CRT indications.
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May increase perforation risk without LVEF gains in CRT; leaves open optimal strategy pending randomized trials.
Cano et al. (2023) conducted a cohort in Indication for left bundle branch area pacing (n=323). Left bundle branch pacing (LBBP) strategy vs. Left ventricular septal pacing (LVSP) strategy was evaluated on Acute septal perforation (p=0.026). An implant strategy aiming for left bundle branch pacing resulted in a higher rate of acute septal perforation compared to accepting left ventricular septal pacing (11.8% vs. 4.9%, p=0.026).
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