Left Bundle Branch Area Pacing: Implant Technique, Definitions, Outcomes, and Complications

• Published in: Current cardiology reports Vol. 23; no. 11; p. 155
• Main Authors: Cano, Óscar, Vijayaraman, Pugazhendhi
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-11-2021
• Subjects: Cardiology; Medicine; Medicine & Public Health; New Therapies for Cardiovascular Disease (AA Bavry and MR Massoomi; Section Editors; Topical Collection on New Therapies for Cardiovascular Disease; Conduction system pacing; His bundle pacing; Left bundle branch pacing
• ISSN: 1523-3782; 1534-3170
• DOI: 10.1007/s11886-021-01585-1

Purpose of Review
Conduction system pacing (CSP) has emerged during the last few years as the cornerstone of physiological pacing. Two different CSP modalities have been described so far: His bundle pacing (HBP) and left bundle branch area pacing (LBBAP). This review will be focused on the description of LBBAP technique, definitions, outcomes, and complications.
Recent Findings
Large observational studies have demonstrated the safety and feasibility of LBBAP in different scenarios. LBBAP has been associated with excellent pacing electrical parameters (pacing threshold and R wave sensing) and low complication rates including lead revision < 1%. In patients with cardiac resynchronization therapy (CRT) indication, LBBAP has shown significant improvement of functional class and left ventricular ejection fraction during short-term follow-up.
Summary
LBBAP is a relatively new CSP modality showing excellent results for patients with conventional bradycardia pacing indications and promising expectations about its potential role for CRT.