Arrhythmias & electrophysiology
Electrophysiologic characteristics and clinical correlation of right ventricular activation during left bundle branch area pacing (RV-LBBAP study)
Authors' conclusion
Physiologic RBB-mediated (type I) activation of the right ventricle was the most common pattern observed during S-LBBP in patients with intact retrograde HB activation. Type III pattern was the most common pattern observed during NS-LBBP with fusion of multiple wavefronts from anterograde RBB activation, myocardial, and transverse interbundle connections.
Study context
- Population
- Consecutive patients with successful left bundle branch area pacing (LBBAP), without right bundle branch (RBB) block, right ventricular (RV) paced rhythm or suboptimal intracardiac electrograms94% LBBP
- Participants
- 86 patients
- Comparison
- Selective LBBP (S-LBBP) vs nonselective LBBP (NS-LBBP)
- S-LBBPn = 39
- NS-LBBPn = 44
- Outcome
- RV activation pattern by RBB mapping (type I RBB mediated, type II transseptal, type III fusion)
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
RV activation pattern, baseline normal QRS (n = 47)
| Group | Value | Type I pattern | Type III pattern |
|---|---|---|---|
| S-LBBP | 87% | n = 34 [87%] | |
| NS-LBBP | 91% | n = 40 [91%] |
Value
S-LBBP87%
NS-LBBP91%
Type I pattern
S-LBBPn = 34 [87%]
NS-LBBP— not stated in the abstract
Type III pattern
S-LBBP— not stated in the abstract
NS-LBBPn = 40 [91%]
Further findings
Nonselective to selective capture transition
- Nonselective to selective capture transition
- 85% (n = 73)
No retrograde His bundle (HB) activation vs retrograde HB activation
- Without retrograde HB activation: higher LV end-diastolic diameter, lower LVEF, prolonged HV interval
Original publication
Electrophysiologic characteristics and clinical correlation of right ventricular activation during left bundle branch area pacing (RV-LBBAP study). Heart Rhythm. Published 25 October 2024. doi:10.
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