Arrhythmias & electrophysiologyRandomised controlled trial
Comparison of Pacing Lead Design on Left Bundle Branch Pacing Outcomes
- multicenter, blind-adjudicated, randomized clinical trial
- block randomization in a 1:1 ratio
Authors' conclusion
Among LBBP recipients, SDL compared with LLL resulted in a higher incidence of LLC during follow-up, lower acute LBBP procedural success, and greater acute lead damage during implantation. These findings have significant implications for lead selection in LBBP.(Comparison of Pacing Lead Design on Left Bundle Branch Pacing Outcomes: The LEAD_LBBP Randomized Clinical Trial [LEAD-LBBP]; NCT06318130).
Study context
- Population
- Left bundle branch pacing (LBBP) recipientsmean age 74.9 ± 9.6 years, 97 [44%] female
- Participants
- 226 recipients
- Comparison
- LLL or SDL
- LLLn = 113reference
- SDLn = 113
- Primary endpoint
- Incidence of LLC
- Follow-up
- 12 months
Primary result
As reported in the abstract
Hazard ratio
2.72
95% CI 1.34–5.54
P = 0.006
By group
SDL vs LLL
HR 2.72 (95% CI 1.34–5.54); P = 0.006
- LLC overall
- 36 (16%)
Secondary outcomes
Acute LBBP success
- Acute LBBP success: P = 0.007
Pacing parameters and clinical outcomes
- Comparable between the SDL and LLL groups
- P > 0.05
Safety
| Outcome | SDL | LLL | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| Acute lead damage | 10% | 3% | 3.95 (1.07–14.58) | P = 0.027 | |
| 0.050.21520Odds ratio (log scale) |
Overall complications
- Comparable between the SDL and LLL groups
- P > 0.05
Original publication
Comparison of Pacing Lead Design on Left Bundle Branch Pacing Outcomes. JACC Clin Electrophysiol. Published 27 June 2026. doi:10.1016/j.jacep.2026.06.008
Summarised from the published abstract; every number is checked against it