Arrhythmias & electrophysiology
Exploring Mechanical Synchrony and Myocardial Work Across Different Pacing Locations Within the Left Bundle Branch
Authors' conclusion
In patients with preserved LV ejection fraction, mechanical synchrony and work efficiency were similar across LBB pacing sites. These findings support a pragmatic approach centered on achieving conduction system capture rather than targeting specific anatomical locations.
Study context
- Population
- Patients with preserved left ventricular (LV) ejection fraction who received left bundle branch pacing (LBBP) for bradycardia indications106 with central or peripheral LBB capture classified
- Participants
- 114 patients
- Exposure
- Central and peripheral LBB captures; intrinsic vs paced beats
- Central LBB capturen = 60
- Peripheral LBB capturen = 46
- Outcome
- Capture site
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Global longitudinal strain and myocardial work indices (global work index, global constructive work, global wasted work, global work efficiency) · follow-up
- No significant differences between central and peripheral LBB captures
Global work efficiency, global work index, global constructive work, global wasted work: LBBP vs intrinsic rhythm
- No significant differences compared with intrinsic rhythm; changes from intrinsic to paced rhythm similar between study groups
- Within-patient comparisons in patients with intrinsic rhythm
Original publication
Exploring Mechanical Synchrony and Myocardial Work Across Different Pacing Locations Within the Left Bundle Branch. JACC Clin Electrophysiol. Published 5 March 2026. doi:10.
Summarised from the published abstract; every number is checked against it