Arrhythmias & electrophysiology
Left bundle branch pacing better preserves ventricular mechanical synchrony than right ventricular pacing: a two-centre study
Authors' conclusion
LBBP causes less LV mechanical dyssynchrony than RVP as it preserves a more physiologic electrical conduction.
Study context
- Population
- Patients with pacing indication for bradycardia
- Participants
- 60 patients
- Exposure
- Left bundle branch pacing (LBBP) vs right ventricular pacing (RVP)
- LBBPn = 31
- RVPn = 29reference
- Outcome
- LV mechanical dyssynchrony (lateral wall-septal wall [LW-SW] work difference)
- Follow-up
- Last
Methodological detailstwo-centre, Echocardiography before and shortly after pacemaker implantation and at 1-year follow-up
- Two-centre
- Echocardiography before and shortly after pacemaker implantation and at 1-year follow-up
Main finding
As reported in the abstract
LW-SW work difference
P < 0.01
Observational data: associations, not effects.
Further findings
| Outcome | LBBP | RVP | P value |
|---|---|---|---|
| ΔLVEF · 1 year | 0.3 ± 4.1 % | −7.4 ± 7.0 % | P < 0.01 |
| ΔLV GLS · 1 year | −1.4 ± 2.5 % | −4.8 ± 4.0 % | P < 0.01 |
Septal flash, apical rocking, septal strain patterns
- RVP more often induced septal flash or apical rocking and more advanced strain patterns vs LBBP
Correlation of ΔLW-SW work difference with left ventricular (LV) adverse remodelling and dysfunction
- LV adverse remodelling
- r = 0.42, P < 0.01
- ΔLVEF
- r = −0.61, P < 0.01
- ΔLVGLS
- r = −0.38, P = 0.02
- Independently correlated
Original publication
Left bundle branch pacing better preserves ventricular mechanical synchrony than right ventricular pacing: a two-centre study. Eur Heart J Cardiovasc Imaging. Published 2 November 2023. doi:10.
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