Arrhythmias & electrophysiology
Left Ventricular Mechanical Insights Into Left Bundle Branch Pacing and Left Ventricular Septal Pacing
Authors' conclusion
In patients with preserved or moderately reduced LV ejection fraction, LBBP exhibited LV mechanical efficiency comparable to that of spontaneous LV activation. Conversely, LVSP is a valuable option, but LV mechanics is impaired, showing a reduced GWE of the left ventricle. (Evaluation of Contemporary Cardiac Stimulation in Clinical Practice: Left, Biventricular, Right, and Conduction System Pacing [TREEBEARD]; NCT06324682).
Study context
- Population
- Patients with normal or moderately reduced left ventricular (LV) ejection fraction receiving left bundle branch area pacing (LBBAP), from the TREEBEARD prospective studymean age 73.3 ± 14.3 years, 74.8% male
- Participants
- 155 patients
- Exposure
- Left bundle branch pacing (LBBP) vs LV septal pacing (LVSP)
- LBBPn = 102
- LVSPn = 53
- Outcome
- MW indices, spontaneous rhythm vs LBBP (LBBP group)
Main finding
As reported in the abstract
- All myocardial work (MW) indices displayed a strong correlation between values recorded during spontaneous rhythm and LBBP
Observational data: associations, not effects.
Further findings
MW indices, spontaneous rhythm vs LVSP (LVSP group)
- Global work index
- r = 0.535; P = 0.004
- Global constructive work
- r = 0.587; P = 0.009
- Global work efficiency
- r = 0.503; P = 0.01
- Global wasted work (not statistically significant)
- r = 0.641; P = 0.13
- Moderate correlations
Original publication
Left Ventricular Mechanical Insights Into Left Bundle Branch Pacing and Left Ventricular Septal Pacing. JACC Clin Electrophysiol. Published 28 May 2025. doi:10.
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