Heart failure & cardiomyopathies
Effect of leadless left ventricular endocardial and left bundle branch area pacing on biventricular repolarization metrics
Authors' conclusion
Optimized leadless LV endocardial lateral wall pacing and LBBAP improve ECGi-derived ventricular repolarization metrics. LV-only pacing seemed superior to endocardial BiVP, potentially reflecting repolarization heterogeneity caused by a collision of 2 paced wavefronts.
Study context
- Population
- Patients with leadless endocardial cardiac resynchronization therapy (CRT) systems
- Participants
- 10 patients
- Comparison
- Optimal leadless left ventricular (LV) endocardial pacing setting vs baseline
- LV lateral walln = 5
- Left bundle branch area pacing (LBBAP)n = 5
- Outcome
- Acute reduction from baseline (RV pacing or underlying rhythm) of ECGi-derived repolarization metrics
Methodological detailsacute temporary pacing study, electrocardiographic imaging (ECGi)
- Acute temporary pacing study
- ECGi
Main finding
As reported in the abstract
Reduction in biventricular dispersion of repolarization with optimal leadless pacing setting
| Group | Value | P |
|---|---|---|
| LBBAP | 29.3% ± 15% | P = .01 |
| LV lateral wall | 18% ± 12% | P = .03 |
Value
LBBAP29.3% ± 15%
LV lateral wall18% ± 12%
P
LBBAPP = .01
LV lateral wallP = .03
- Overall improvement in biventricular dispersion of repolarization
- 23.7% ± 14% (P < .01)
Further findings
Activation-recovery interval dispersion and biventricular repolarization gradients
- Similar results to dispersion of repolarization
LV-only pacing vs biventricular pacing (BiVP)
- Most pronounced improvements with LV-only pacing (LBBAP or AV-optimized LV pacing) rather than BiVP
Original publication
Effect of leadless left ventricular endocardial and left bundle branch area pacing on biventricular repolarization metrics. Heart Rhythm. Published 26 May 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →