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July 4, 2024Heart RhythmOpen Access

Left bundle branch area pacing (LBBAP) had a 2.5% lead complication rate at 36 months compared to 6.3% for His-bundle pacing (HBP), along with lower pacing thresholds (P<0.001).

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Why the study?

Conduction system pacing has been used as an alternative for pacemaker-indicated patients requiring ventricular pacing, but real-world safety and performance data were needed.

Does LBBAP improve safety and electrical performance compared to HBP in patients requiring ventricular pacing?

Population

2342 patients undergoing pacemaker implantation for HBP or LBBAP with a Medtronic Model 3830 lead

Comparison

LBBAP vs HBP

Design

Multicenter observational registry analysis

Key result

Left bundle branch area pacing (LBBAP) had a 2.5% lead complication rate at 36 months compared to 6.3% for His-bundle pacing (HBP), along with lower pacing thresholds (P<0.001).

Authors

PVPugazhendhi VijayaramanMWMichael A. WestTDThomas Dresing

Discussion

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Member takes

Overview

LBBAP may reduce lead issues versus HBP; Level 4 data leave superiority open pending randomized trials.

Study Design

Type

Observational (n=2,342)

Multicenter

Yes

Structured PICO

Does LBBAP improve safety and electrical performance compared to HBP in patients requiring ventricular pacing?

P
Population
2,342 patients (mean age 74, 38.9% female) requiring ventricular pacing who underwent left bundle branch area pacing or His-bundle pacing, followed for up to 36 months.
E
Exposure
Left bundle branch area pacing (LBBAP) using a Medtronic Model 3830 lead
C
Comparator
His-bundle pacing (HBP) using a Medtronic Model 3830 lead
O
Outcome
Lead-related complications and pacing capture thresholdsafety

Main Result

Absolute Event Rate: 2.5% vs 6.3%

In a real-world registry, LBBAP was associated with lower lead complication rates and better electrical parameters compared to HBP over 3 years.

Cite This Study

Vijayaraman et al. (2024) conducted an observational in Pacemaker indication requiring ventricular pacing (n=2,342). Left bundle branch area pacing (LBBAP) vs. His-bundle pacing (HBP) was evaluated on Lead-related complications at 36 months. Left bundle branch area pacing (LBBAP) had a 2.5% lead complication rate at 36 months compared to 6.3% for His-bundle pacing (HBP), along with lower pacing thresholds (P<0.001).

synapsesocial.com/papers/6aa00aaadd8cd84ce6d55cc6https://doi.org/10.1016/j.hrthm.2024.06.061
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Also Consider

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

  1. 1Safety and long-term performance of the Medtronic 3830 lead in His-bundle vs. Left bundle branch area pacing: A single-center 5-year experience2024
  2. 2A single‐center experience with early adoption of physiologic pacing approaches2021 · 6 citations
  3. 3Clinical outcomes of left bundle branch area pacing compared to His bundle pacing2022 · 31 citations
  4. 493 Conduction system pacing in a district general hospital: a five-year experience2024
  5. 5Long term performance and safety of His bundle pacing: A multicenter experience2019 · 157 citations