Key result
LBBAP linked to ~72% lower risk of new-onset AF versus RVP.
Why the study?
It was uncertain whether left bundle branch area pacing reduces the risk of new-onset atrial fibrillation compared with right ventricular pacing.
Does left bundle branch area pacing reduce new-onset atrial fibrillation in patients with indications for dual-chamber pacemaker implant compared with right ventricular pacing?
Population
527 patients with indications for dual-chamber pacemaker implant and no history of AF
Comparison
Left bundle branch area pacing vs right ventricular pacing
Design
Two-centre prospective cohort study
Follow-up
Mean 11.1 months
Authors
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Supports LBBAP to lower new-onset AF risk in pacemaker patients; leaves open confirmation in randomized trials before practice change.
Cohort (n=527)
Yes
Does left bundle branch area pacing reduce new-onset atrial fibrillation in patients with indications for dual-chamber pacemaker implant compared with right ventricular pacing?
Hazard Ratio: 0.278 (95% CI 0.156–0.496)
Absolute Event Rate: 7.4% vs 17%
p-value: p=<0.001
Left bundle branch area pacing significantly reduces the risk of new-onset atrial fibrillation compared with right ventricular pacing, particularly in patients with a high ventricular pacing burden (≥20%).
Zhu et al. (2022) conducted a cohort in Indications for dual-chamber pacemaker implant and no history of atrial fibrillation (n=527). Left bundle branch area pacing (LBBAP) vs. Right ventricular pacing (RVP) was evaluated on Time to the first occurrence of atrial fibrillation detected by pacemaker programming or surface electrocardiogram (HR 0.278, 95% CI 0.156-0.496, p=<0.001). Left bundle branch area pacing was associated with a lower risk of new-onset atrial fibrillation compared with right ventricular pacing (HR 0.278; 95% CI 0.156-0.496; P<0.001).
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