Arrhythmias & electrophysiology
Left bundle branch area pacing preserves left ventricular ejection fraction in patients with preserved systolic function: A comparison with right ventricular pacing and the influence of left bundle branch capture
Authors' conclusion
Regardless of LBB capture, LBBAP was associated with significantly lower PICM incidence and better LVEF preservation compared with RVP.
Study context
- Population
- Patients with ≥20% ventricular pacing and pre-operative LV ejection fraction (LVEF) ≥50%patients included
- Participants
- 273 patients
- Exposure
- Left bundle branch area pacing (LBBAP) vs right ventricular pacing (RVP)
- RVPn = 137
- LBBAPn = 110
- Outcome
- PICM incidence (absolute LVEF decline >10% with a final LVEF <50%)
- Follow-up
- Mean 49 ± 31 months (RVP) and 24 ± 12 months (LBBAP)
Main finding
As reported in the abstract
- LBBAP vs RVP: log-rank P = .003
Observational data: associations, not effects.
Further findings
Mean, %
| Outcome | RVP | LBBAP | LBBP | LVSP | P value | |
|---|---|---|---|---|---|---|
| ΔLVEF (pre-operative to 1-year post-operative LVEF)RVP vs LBBAP · smaller ΔLVEF decline with LBBAP | −7 (SD 11) | −2 (SD 8) | Not reported in the abstract | Not reported in the abstract | P < 0.01 | LBBP, LVSP: not reported in the abstract |
Pacing-induced cardiomyopathy (PICM) incidence and ΔLVEF, LBB pacing (LBBP) vs LVSP
- No significant differences between LBBP and LVSP in PICM incidence or ΔLVEF
Original publication
Left bundle branch area pacing preserves left ventricular ejection fraction in patients with preserved systolic function: A comparison with right ventricular pacing and the influence of left bundle branch capture. Heart Rhythm. Published 29 August 2025. doi:10.
Summarised from the published abstract; every number is checked against it