Arrhythmias & electrophysiologyResearch article
Anatomical computed tomography-based framework for optimizing left bundle branch area pacing of the human cardiac conduction system
- Computed tomography (CT)-based framework
- 3-dimensional models from coronary CT scans
- simulated leads
Authors' conclusion
This suggested that a CT-derived framework can be used to identify the septal fascicle regions as the most practical LBBAP targets, targeting proximity to the conduction system.
Study context
- Population
- Patients with coronary CT scanspatients whose coronary CT scans were used to build 3-dimensional models
- Participants
- 27 patients
- Comparison
- septal targets vs superior vs inferior
Main finding
As reported in the abstract
Horizontal position of targets in right anterior oblique 30° · 20 mm from each tricuspid annulus
- all targets clustered at approximately one-third of the horizontal His distance-to-RV apex
Further findings
| Outcome | septal targets | superior | inferior |
|---|---|---|---|
| Vertical displacement (% of reference segment) | −1.6 ± 10.8 % | +15.8 ± 6.8 % | −32.4 ± 18.7 % |
| Proximity to the left bundle origins | 18.9 ± 4.5 mm | Not reported in the abstract | Not reported in the abstract |
Proximity to the left bundle origins
- septal fascicular targets provided the best balance of feasibility and precision, with the closest proximities
Original publication
Anatomical computed tomography-based framework for optimizing left bundle branch area pacing of the human cardiac conduction system. Heart Rhythm. Published 3 August 2026. doi:10.1016/j.hrthm.2026.07.039
Summarised from the published abstract; every number is checked against it