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Left bundle branch pacing: A comprehensive review
Author(s) -
Ponnusamy Shunmuga Sundaram,
Arora Vanita,
Namboodiri Narayanan,
Kumar Vivek,
Kapoor Aditya,
Vijayaraman Pugazhendhi
Publication year - 2020
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14681
Subject(s) - medicine , cardiac pacing , cardiology , troubleshooting , bundle , ventricular pacing , electrical conduction system of the heart , heart failure , cardiac resynchronization therapy , electrocardiography , ejection fraction , materials science , reliability engineering , engineering , composite material
Abstract Cardiac pacing is the only effective therapy for patients with symptomatic bradyarrhythmia. Traditional right ventricular apical pacing causes electrical and mechanical dyssynchrony resulting in left ventricular dysfunction, recurrent heart failure, and atrial arrhythmias. Physiological pacing activates the normal cardiac conduction, thereby providing synchronized contraction of ventricles. Though His bundle pacing (HBP) acts as an ideal physiological pacing modality, it is technically challenging and associated with troubleshooting issues during follow‐up. Left bundle branch pacing (LBBP) has been suggested as an effective alternative to overcome the limitations of HBP as it provides low and stable pacing threshold, lead stability, and correction of distal conduction system disease. This paper will focus on the implantation technique, troubleshooting, clinical implications, and a review of published literature of LBBP.