Left bundle branch pacing is a promising treatment modality for patients requiring cardiac pacing, though long-term effects, efficacy, and complications require further research.
Does left bundle branch pacing improve clinical outcomes compared to other pacing modalities in patients requiring cardiac pacing?
Left bundle branch pacing is a promising alternative to traditional pacing modalities for patients with LBBB and heart failure, but requires further research on long-term outcomes and complications.
Cardiac pacing refers to the implantation tool serving as a treatment modality for various indications, the most common of which is symptomatic bradyarrhythmia. Left bundle branch pacing has been noted in the literature to be safer than biventricular pacing or His-bundle pacing in patients with left bundle branch block (LBBB) and heart failure, thereby becoming the focus of further research on cardiac pacing. A review of the literature was conducted using a combination of keywords, including "Left Bundle Branch Block," "Procedural techniques," "Left Bundle Capture," and "Complications." The following factors have been investigated as key criteria for direct capture: paced QRS morphology, peak left ventricular activation time, left bundle potential, nonselective and selective left bundle capture, and programmed deep septal stimulation protocol. In addition, complications of LBBP, inclusive of septal perforation, thromboembolism, right bundle branch injury, septal artery injury, lead dislodgement, lead fracture, and lead extraction, have also been elaborated on. Despite clinical implications based on clinical research comparing the use of LBBP with other forms such as right ventricular apex pacing, His-bundle pacing, biventricular pacing, and left ventricular septal pacing, a paucity in the literature on long-term effects and efficacy has been noted. LBBP can thus be considered to have a promising future in patients requiring cardiac pacing, assuming that additional research on clinical outcomes and the limitation of significant complications such as thromboembolism can be established.
Katta et al. (Mon,) conducted a review in Symptomatic bradyarrhythmia, left bundle branch block (LBBB), and heart failure. Left bundle branch pacing (LBBP) vs. Right ventricular apex pacing, His-bundle pacing, biventricular pacing, and left ventricular septal pacing was evaluated. Left bundle branch pacing is a promising treatment modality for patients requiring cardiac pacing, though long-term effects, efficacy, and complications require further research.