Arrhythmias & electrophysiology

Implantation of standard defibrillator leads in the left bundle branch area: Experience from an international cohort

Heart RhythmPublished Retrospective

Authors' conclusion

LBBAD with standard stylet-driven lead is safe and feasible, with stable electrical, electrocardiographic, and echocardiographic parameters at midterm follow-up.

Study context

Population
Implantable cardioverter-defibrillator patients undergoing left bundle branch area defibrillation (LBBAD) implantationpatients included
Participants
163 patients
Outcome
Implantation success rate
Methodological details12 international centers
  • 12 international centers

Main finding

As reported in the abstract

Implantation success rate

88%

Observational data: associations, not effects.

Further findings

Defibrillation testing

Defibrillation testing performed, effective in all cases
85 patients

Paced electrocardiographic parameters

ms

Paced unipolar QRS duration
125 (119-135)
V6 R-wave peak time
76 (70-85)
V6-V1 interpeak interval
44 (45-54)

Electrical parameters

Capture threshold
0.8 V/0.4 ms (0.5-1.1)
Sensing amplitude
9.0 mV (6.2-12)
Pacing impedance
580 Ω (493-650)
High-voltage impedance
66 Ω (60-75)
Electrical parameters remained favorable over follow-up
8 months (3-13)

Left ventricular ejection fraction · last follow-up

Baseline
30% (26%-35%)
Last follow-up
36% (31%-46%)
  • P < .001

Appropriate and effective shocks

Appropriate and effective shocks
13
Patients affected
8 patients (4.9%)
No ineffective shocks were reported

Safety

Lead explantation · more than 1 year after implantation

LBBAD leads explanted without any complication
2

Deaths related to LBBAD

No deaths were related to LBBAD

Original publication

Implantation of standard defibrillator leads in the left bundle branch area: Experience from an international cohort. Heart Rhythm. Published 23 March 2026. doi:10.1016/j.hrthm.2026.03.1903

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