Acute procedural outcomes of left bundle branch area pacing compared to His-bundle pacing

Abstract Funding Acknowledgements Type of funding sources: None. Background Conduction system pacing (CSP), encompassing left bundle branch area (LBBAP) and His-bundle (HBP), is a novel strategy, which overcomes limitations conventional right ventricular pacing. Feasibility early safety both strategies have been established previously. While HBP mentioned as an alternative strategy in the latest European American guidelines, implantation recommendations regarding LBBAP are scarce. Notably, was described to be associated with significantly higher procedural failure rate compared LBBAP, making it potentially more contestable. Purpose To compare outcomes after lead implantation. Methods We prospectively assessed 303 consecutive CSP attempts at our center from 08/2018 11/2022. 81% all implantations were performed by two high-volume device implanters. Successful conduction according standard criteria (HBP: QRS morphology, R-wave peak time V6, programmed stimulation, visibility His potential; LBBAP: V1-V6-interpeak interval, stimulation or potential) thresholds <4.0V/1.0ms; <2V/0.5ms). Patient selection used operator’s discretion. Results Patients attempt younger had narrower complex but did not differ respect function dimension (table showing percentages median values/interquartile ranges). systems often implanted lieu CRT, whereas commonly case AV block without heart (table). Acute success rate, overall procedure duration fluoroscopy better during (all p<0.001). Success rates, sensing values capture (@1ms for @0.5ms LBBAP) superior systems, while achieved paced slightly shorter (table, figure 1). Conclusion rates acute favor systems.