Arrhythmias & electrophysiology
Understanding electromechanics of left bundle branch area pacing: Association between electrical synchrony, mechanical synchrony, and myocardial work parameters
Authors' conclusion
Electrical p-QRS complex parameters in LBBAP were linked to mechanical synchrony and MW, emphasizing the importance of the QRS characteristics.
Study context
- Population
- Patients who underwent successful left bundle branch area pacing (LBBAP) implantation for bradycardia pacingpatients who underwent successful LBBAP implantation
- Participants
- 149 patients
- Exposure
- Association between paced electrocardiographic (ECG) measurements and mechanical synchrony and myocardial work (MW) parameters (linear regression)
- Outcome
- Paced V6-RWPT vs IVMD and GWW
Main finding
As reported in the abstract
Shorter paced V6-RWPT, interventricular mechanical delay (IVMD) (higher)
β = −0.146
P = .096
Shorter paced V6-RWPT, global wasted work (GWW) (lower)
β = 0.168
P = .057
Observational data: associations, not effects.
Further findings
Paced V1-RWPT and V6-V1 interpeak interval vs GWW and IVMD
- Paced V1-RWPT, greater GWW
- β = 0.205; P = .048
- Paced V1-RWPT, higher IVMD
- β = 0.203; P = .046
- V6-V1 interpeak interval, IVMD
- β = 0.259; P = .009
Paced aVL-RWPT vs mechanical synchrony and MW indices
- Longer aVL-RWPT, increased peak strain dispersion (PSD)
- β = 0.184; P = .050
- Longer aVL-RWPT, increased global constructive work (GCW)
- β = 0.263; P = .005
- Longer aVL-RWPT, increased GWW
- β = 0.253; P = .006
- Longer aVL-RWPT, decreased global work efficiency (GWE)
- β = −0.205; P = .028
Paced QRS (p-QRS) duration vs IVMD and GWW
- Longer p-QRS duration was associated with increased IVMD and GWW
Subgroup analyses by capture type
- Subgroup analyses revealed differences based on capture type
Original publication
Understanding electromechanics of left bundle branch area pacing: Association between electrical synchrony, mechanical synchrony, and myocardial work parameters. Heart Rhythm. Published 8 September 2025. doi:10.
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