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June 24, 2022Journal of Cardiovascular Electrophysiology

LBBAP is linked to ~27% lower mechanical dyssynchrony bandwidth versus RVSP.

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Why the study?

Left bundle branch area pacing has emerged as a physiological pacing strategy, but its usefulness in reducing mechanical dyssynchrony compared with right ventricular septal pacing needed investigation.

Does left bundle branch area pacing (LBBAP) reduce mechanical dyssynchrony compared to right ventricular septal pacing (RVSP) in patients undergoing pacemaker implantation?

Population

39 LBBAP patients, 42 RVSP patients, and 93 healthy control participants

Comparison

LBBAP vs RVSP vs healthy controls

Design

Retrospective study

Key result

Left bundle branch area pacing reduced mechanical dyssynchrony compared with right ventricular septal pacing, showing lower bandwidth (74° vs 102°, p=0.009) and phase standard deviation.

Authors

KMKeisuke MiyajimaTUTsuyoshi UrushidaTTTakumi Tamura

Discussion

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Member takes

Overview

LBBAP was associated with less acute dyssynchrony than RVSP; hypothesis-generating for physiological pacing benefits, pending RCTs.

Study Design

Type

Cohort (n=174)

Structured PICO

Does left bundle branch area pacing (LBBAP) reduce mechanical dyssynchrony compared to right ventricular septal pacing (RVSP) in patients undergoing pacemaker implantation?

P
Population
174 participants, including 39 patients with left bundle branch area pacing (LBBAP), 42 patients with right ventricular septal pacing (RVSP), and 93 healthy controls.
I
Intervention
Left bundle branch area pacing (LBBAP)
C
Comparator
Right ventricular septal pacing (RVSP) and healthy controls
O
Outcome
Cardiac mechanical dyssynchrony assessed by phase analysis parameters (bandwidth, phase standard deviation [PSD], entropy) and regional wall motion analysis parameters (MDTES, SDTES, DTES-LS) using myocardial perfusion scintigraphy (SPECT)surrogate

LBBAP reduces mechanical dyssynchrony and achieves more physiological ventricular activation compared to RVSP in the acute phase of pacemaker implantation.

Cite This Study

Miyajima et al. (2022) conducted a cohort in Pacemaker implantation (n=174). Left bundle branch area pacing (LBBAP) vs. Right ventricular septal pacing (RVSP) was evaluated on Mechanical dyssynchrony assessed by phase analysis (bandwidth, phase standard deviation, entropy) and regional wall motion analysis. Left bundle branch area pacing reduced mechanical dyssynchrony compared with right ventricular septal pacing, showing lower bandwidth (74° vs 102°, p=0.009) and phase standard deviation.

synapsesocial.com/papers/6a16dd85c7240d1a707bb5c9https://doi.org/10.1111/jce.15609
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Assessment of Cardiac Function and Ventricular Mechanical Synchronization in Left Bundle Branch Area Pacing by Speckle Tracking and Three-Dimensional Echocardiography2022 · 14 citations
  2. 2Left bundle branch area pacing is superior to right ventricular septum pacing concerning depolarization‐repolarization reserve2019 · 73 citations
  3. 3Comparisons of electrophysiological characteristics, pacing parameters and mid- to long-term effects in right ventricular septal pacing, right ventricular apical pacing and left bundle branch area pacing2022 · 10 citations
  4. 4Comparing Ventricular Synchrony in Left Bundle Branch and Left Ventricular Septal Pacing in Pacemaker Patients2021 · 72 citations
  5. 5Comparable acute hemodynamic effects of left bundle branch pacing delivered from the right and left ventricular septum2026