Arrhythmias & electrophysiology
Left bundle branch area pacing improves right ventricular function and synchrony
Authors' conclusion
LBBAP has a favorable impact on RV function. A basal LBBAP position is associated with worsening TR.
Study context
- Population
- Patients undergoing left bundle branch area pacing (LBBAP); 62 men (50.8%), mean age 76.5 ± 11.4 years
- Participants
- 122 patients
- Exposure
- Before vs after LBBAP
- Outcome
- Long-term RV performance (RV free wall strain, TAPSE, fractional area change, tricuspid annular systolic velocity) and TR
- Follow-up
- Median 21 months (18-24.5 months)
Main finding
As reported in the abstract
RV free wall strain · median 21 months
Baseline
15.2
± 5.8
Follow-up
16.4
± 5.5
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | B (95% CI) | P value |
|---|---|---|
| Predictor of improved RV function: LVEFIndependent predictor | 3.51 (1.39–8.9) | P = 0.01 |
Disappearance of reverse septal flash and basal bulge (present at baseline)
- Reverse septal flash disappeared
- 22 of 23 patients (96%)
- Basal bulge disappeared
- 15 of 22 patients (68%)
Right ventricular (RV) function improvement by baseline reverse septal flash
- RV function improvement significantly higher when reverse septal flash present at baseline (14 patients vs 11 patients)
- P = 0.02
Safety
- Lead-TV distance <24.5 mm associated with tricuspid regurgitation (TR) progression
Original publication
Left bundle branch area pacing improves right ventricular function and synchrony. Heart Rhythm. Published 13 May 2024. doi:10.
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