Arrhythmias & electrophysiologyResearch article
Left ventricular subendocardial pacing provides the same left ventricular synchrony and work efficiency as direct left bundle branch capture
- Consecutive cardiac resynchronization therapy (CRT) patients with transition from nonselective left bundle branch capture to LVSeP during decremental output pacing were enrolled
Authors' conclusion
In CRT candidates, LVSeP preserved LV synchrony and acute hemodynamic response at the same level as direct LBBP. Further clinical research is warranted to better understand the differences between various types of left septal pacing.
Study context
- Population
- CRT patients with transition from nonselective left bundle branch capture to left ventricular (LV) subendocardial pacing during decremental output pacing
- Participants
- 21 patients
- Comparison
- compare electrical ventricular synchrony and acute hemodynamic response between LBB pacing (LBBP) and LVSeP
Main finding
As reported in the abstract
QRS duration
P = 0.26
Further findings
V6RWPT · longer with LVSeP
P < 0.001
LV synchrony · no significant difference
P = 0.21
Average systolic blood pressure · no significant difference
P = 0.78
| Outcome | LVSeP | LBBP | P value |
|---|---|---|---|
| Post-pacing isoelectric interval · longer with LVSeP | 48 ± 9 | 39 ± 9 | P < 0.001 |
Intracardiac mapping of the LV septum (one patient)
- both LVSeP and LBBP activated the LV septum at the recording site via the His-Purkinje system
Original publication
Left ventricular subendocardial pacing provides the same left ventricular synchrony and work efficiency as direct left bundle branch capture. Heart Rhythm. Published 7 January 2026. doi:10.1016/j.hrthm.2025.12.047
Summarised from the published abstract; every number is checked against it