Key result
LBBAP is linked to transseptal complications including lead dislodgement, myocardial injury, and ~14% septal perforation.
Why the study?
Left bundle branch area pacing offers more physiological pacing and avoids ventricular free wall perforation but introduces new complications related to the transseptal lead placement route.
This review highlights the complications associated with the transseptal route used in left bundle branch area pacing and discusses strategies for avoidance and management.
Alerts clinicians to transseptal complications with left bundle branch area pacing; extends knowledge but leaves optimal management open.
Left bundle branch area pacing has been a breakthrough in pacing therapy and is being increasingly adopted. It delivers a more physiological form of pacing compared with right ventricular and biventricular pacing and also avoids the risk of perforation of the ventricular free wall. However, the therapy comes at the price of new complications related to the transseptal route for placing the lead. This article provides an update on these complications and discusses how to avoid and manage these adverse events.
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Stempfel et al. (2025) conducted a review in Complications of Left Bundle Branch Area Pacing (LBBAP). Left Bundle Branch Area Pacing (LBBAP) was evaluated. Left bundle branch area pacing is associated with complications related to the transseptal route, including septal perforation (up to 14%), lead dislodgement, and myocardial injury.
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