Arrhythmias & electrophysiology
Mechanical resynchronization in left bundle branch block achieved by conduction system pacing: A strain-based analysis
- multicenter study
Authors' conclusion
LBBAP provides substantial mechanical resynchronization with immediate and progressive improvements in septal mechanics. Resynchronization was not significantly different between LBBP and LVSP, but was attenuated in DSP, where residual dyssynchrony was associated with lower LVEF 1-year after implantation.
Study context
- Population
- Patients undergoing left bundle branch area pacing (LBBAP) with left bundle branch block (LBBB) or need for upgrade from right ventricular pacing, across the full range of left ventricular ejection fraction (LVEF)
- Comparison
- Resynchronization between left bundle branch pacing (LBBP), LV septal pacing (LVSP) and deep septal pacing (DSP)
Main finding
As reported in the abstract
Type of capture during follow-up · follow-up
Further findings
Septal strain patterns · after implantation
- Septal strain patterns improved immediately and progressively after implantation
- P = 0.01
Global longitudinal strain (GLS) · baseline to follow-up
- GLS at baseline
- −12 ± 6%
- GLS at follow-up
- −15 ± 6%
- P
- P < 0.001
Resynchronization by capture type · 1 year
- Inferior in DSP, lower Δ mid-septal peak septal strain
- P = 0.004
- Inferior in DSP, lower ΔLVEF
- P = 0.03
- Not significantly different between LBBP and LVSP
Reverse remodeling (regression analysis)
- Both LBBB-stages and type of LBBAP-capture were associated with reverse remodeling following LBBAP
Original publication
Mechanical resynchronization in left bundle branch block achieved by conduction system pacing: A strain-based analysis. Heart Rhythm. Published 5 May 2026. doi:10.1016/j.hrthm.2026.04.055
Summarised from the published abstract; every number is checked against it