Arrhythmias & electrophysiology
A Novel Method for Assessing Left Bundle Branch Capture Using the Bidirectional Conduction Time Difference Between Left Bundle Branch Area Pacing and Coronary Sinus Leads
Authors' conclusion
ΔLBB-CS ≥ 21.5ms may serve as a novel adjunctive marker of LBB capture during LOT-CRT, with greater diagnostic accuracy at a 20.5 ms cutoff in patients with baseline LBBB.
Study context
- Population
- Patients undergoing de novo left bundle branch-optimized cardiac resynchronization therapy25 had left bundle branch block and 17 had non-specific intraventricular conduction delay
- Participants
- 60 patients
- Exposure
- ΔLBB-CS ([coronary sinus (CS)-to-LBBAP] - [left bundle branch area pacing (LBBAP)-to-CS]) was compared between nonselective left bundle branch (LBB) pacing (nonselective LBB pacing (NS-LBBP)) and left ventricular septal pacing (LVSP)
- NS-LBBPn = 43
- LVSPn = 29
- Outcome
- LBB capture confirmed
Main finding
As reported in the abstract
LBB capture confirmed
45 patients
75.0%
Observational data: associations, not effects.
Further findings
LBBAP-to-CS conduction time
| Outcome | NS-LBBP | LVSP | P value |
|---|---|---|---|
| ΔLBB-CSGreater during NS-LBBP than LVSP | 27.5 ± 9.9 ms | 7.9 ± 7.4 ms | P < 0.01 |
LBBAP-to-CS conduction time
- CS-to-LBBAP conduction time (n=60): 143.4±28.5 ms
ΔLBB-CS for LBB capture (ROC analysis)
- Cutoff
- 21.5 ms
- Sensitivity
- 74.4%
- Specificity
- 100%
- AUC
- 0.95
ΔLBB-CS for LBB capture in patients with baseline LBBB (n=25)
- Cutoff
- 20.5 ms
- Sensitivity
- 92.9%
- Specificity
- 100%
- AUC
- 0.99
Original publication
A Novel Method for Assessing Left Bundle Branch Capture Using the Bidirectional Conduction Time Difference Between Left Bundle Branch Area Pacing and Coronary Sinus Leads. Heart Rhythm. Published 24 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it