Arrhythmias & electrophysiology
Left bundle branch pacing lead for sensing ventricular arrhythmias in implantable cardioverter-defibrillator: A pilot study (LBBP-ICD study)
Authors' conclusion
Sensing from the LBBP lead for arrhythmia detection is safe as ∼90% of the episodes were detected appropriately.
Study context
- Population
- Cardiac resynchronization therapy (CRT)-eligible patients with successful left bundle branch pacing (LBBP)-optimized implantable cardioverter-defibrillator (ICD) or LBBP-optimized CRT with defibrillator
- Participants
- 30 patients
- Outcome
- Long-term safety and efficacy of the LBBP lead for appropriate detection of ventricular arrhythmia and delivery of ATP
Main finding
As reported in the abstract
Ventricular arrhythmic events detected · mean follow-up 22.9 ± 12.5 months
- Ventricular arrhythmic events documented
- 254
- Appropriate events
- n = 225 [89%]
- Nonsustained ventricular tachycardia (VT)
- n = 212 episodes [94%]
- VT
- n = 8 [3.5%]
- VF
- n = 5 [2.5%]
- Antitachycardia pacing (ATP) efficacy in terminating VT
- 75%
- Episodes inappropriately detected (T-wave oversensing)
- Eleven percent of episodes (n = 29)
Further findings
LVEF
- LVEF before LBBP
- 29.9% ± 4.6%
- LVEF after LBBP
- 43.9% ± 11.2%
- Change in LVEF
- P < 0.0001
Safety
Inappropriate therapy (ATP)
- Episodes with inappropriate ATP
- 14 episodes (5.5%)
Worsening of tricuspid regurgitation
- Patients with worsening tricuspid regurgitation
- Three patients (10%)
Original publication
Left bundle branch pacing lead for sensing ventricular arrhythmias in implantable cardioverter-defibrillator: A pilot study (LBBP-ICD study). Heart Rhythm. Published 22 December 2023. doi:10.
Summarised from the published abstract; every number is checked against it