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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1449859

Predictors of success in left bundle branch area pacing with stylet-driven pacing leads: A multicenter center investigation

Provisionally accepted
Ga-In Yu Ga-In Yu 1Tae-Hoon Kim Tae-Hoon Kim 2*Jung-Myung Lee Jung-Myung Lee 3Daehoon Kim Daehoon Kim 2Hee Tae Yu Hee Tae Yu 2Jae-Sun Uhm Jae-Sun Uhm 2Boyoung Joung Boyoung Joung 2Hui-Nam Pak Hui-Nam Pak 2Moon-Hyoung Lee Moon-Hyoung Lee 2
  • 1 Gyeongsang National University Changwon Hospital, Changwon, South Gyeongsang, Republic of Korea
  • 2 Yonsei University Health System, Seoul, Republic of Korea
  • 3 Sahmyook Medical Center, Seoul, Republic of Korea

The final, formatted version of the article will be published soon.

    Purpose: Although left bundle branch area pacing (LBBAP) is an emerging conduction system pacing modality, it is unclear which parameters predict procedural success and how many implant attempts are acceptable. This study aimed to assess predictors of successful LBBAP, left bundle branch (LBB) capture, and factors associated with the number of LBBAP implant attempts.This retrospective observational multicenter study was conducted in Korea. LBBAP was attempted in 119 patients; 89.3% of patients had bradyarrhythmia (atrioventricular block 82.4%), and 10.7% of patients had heart failure (cardiac resynchronization therapy) indication. Procedural success and electrophysiological and echocardiographic parameters were evaluated.The acute success rate of lead implantation in LBBAP was 95.8% (114 of 119 patients) and that of LBB capture was 82.4% (98 of 119 patients). Fewer implant attempts were associated with LBBAP success (three or fewer vs. over three times, p = 0.014) and LBB capture (three or fewer vs. over three times, p = 0.010). In the multivariate linear regression, the patients with intraventricular conduction delay (IVCD) required a greater number of attempts than those without IVCD (estimates = 2.33 [0.35-4.31], p = 0.02), and the larger the right atrial (RA) size, the more the attempts required for LBBAP lead implantation (estimates = 2.08 [1.20-2.97], p < 0.001).An increase in the number of implant attempts was associated with LBBAP procedural failure and LBB capture failure. The electrocardiographic parameter IVCD and the echocardiographic parameter RA size may predict the procedural complexity and the number of lead implant attempts for LBBAP.

    Keywords: Conduction system pacing, left bundle branch area pacing, stylet-driven pacing leads, interventricular conduction delay, right atrial diameter

    Received: 16 Jun 2024; Accepted: 04 Sep 2024.

    Copyright: © 2024 Yu, Kim, Lee, Kim, Yu, Uhm, Joung, Pak and Lee. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Tae-Hoon Kim, Yonsei University Health System, Seoul, Republic of Korea

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