Arrhythmias & electrophysiology

Incidence of atrial fibrillation in pacemaker patients with left bundle branch area pacing vs right ventricular pacing leads

Heart RhythmPublished Propensity score-matched comparison in the LATITUDE remote monitoring database

Authors' conclusion

LBBAP was associated with a lower incidence of new-onset AF than RVP in pacemaker patients with a high pacing burden.

Study context

Population
Dual-chamber pacemaker patients without prior atrial fibrillation (AF) with left bundle branch area pacing (LBBAP) or right ventricular pacing (RVP) leads in the right ventricular (RV) portpropensity-matched patients, leads identified: RVP N = 5225, LBBAP N = 4970 · LBBAP 3,943 · RVP 3,943
Participants
7,886 patients
Exposure
LBBAP vs RVP
  • LBBAPn = 3,943
  • RVPn = 3,943
Methodological detailsexact match on percent RV pacing group, landmark analysis
  • Exact match on percent RV pacing group
  • Landmark analysis

Main finding

As reported in the abstract

Patients with 24-hour AF · 21 months of follow-up

P = 0.037

Observational data: associations, not effects.

Further findings

24-hour AF stratified by percent RV pacing ≥ or <40%

24-hour AF stratified by percent RV pacing ≥ or <40% — RVP group had significantly more 24-hour AF when percent pacing was ≥ 40%
P = .004

Propensity match characteristics

Not significantly different between the groups

Original publication

Incidence of atrial fibrillation in pacemaker patients with left bundle branch area pacing vs right ventricular pacing leads. Heart Rhythm. Published 28 August 2026. doi:10.1016/j.hrthm.2026.08.039

Summarised from the published abstract; every number is checked against it

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