Abstract Background: Conventional right ventricular pacing (RVP) causes cardiac dyssynchrony, and increases risk of pacing-induced cardiomyopathy (PICM), heart failure hospitalization and mortality. Left bundle branch area pacing (LBBAP) is a promising physiological pacing modality, we compared the effect of LBBAP on cardiac function with RVP in patients with atrioventricular block (AVB). Methods: A total of 118 patients with AVB who successfully underwent LBBAP were enrolled between June 2019 and June 2022. Among them, 110 patients with a baseline LVEF≥50% were propensity-matched 1:1 with 49 patients who underwent RVP during the same period. Ultimately, 41 patients with well-matched baseline characteristics in both groups were included in the analysis. Echocardiographic parameters and NYHA classification at 1-year follow-up were compared between the groups. Results:Left ventricular ejection fraction (LVEF) remained stable in patients with LVEF≥50% (62.9±2.9 vs 62.9±3.3, P=0.960), and improved significantly in patients with LVEFConclusions: LBBAP might be a preferable pacing modality to improve cardiac remodeling and function in patients requiring high ventricular pacing burden compared with conventional RVP.
Zhang et al. (2025) studied this question.