Electrophysiologic effects of left bundle branch area pacing: comparing left ventricular septal pacing and left bundle branch pacing

Abstract Funding Acknowledgements Type of funding sources: Private company. Main source(s): Medtronic Background Left bundle branch area pacing(LBBAP) has been introduced as a more physiological pacing alternative to anti-bradycardia and an biventricular in cardiac resynchronization therapy (CRT). LBBAP is the common denominator left ventricular septal pacing(LVSP) pacing(LBBP). In LVSP, there only capture myocardium on side interventricular septum, whereas LBBP additional branch(LBB) subsequent Purkinje fibers. Purpose To investigate electrophysiological differences between LVSP. Methods Patients with permanent pacemaker indication due bradycardia or heart failure according current guidelines were included underwent implantation. At baseline during implantation, electrical activation parameters recorded at different sites (Right ventricle, LVSP LBBP), using standard 12-lead ECG BELT. Electrophysiologic measures included: QRS duration, QRSarea calculated from vectorcardiogram after conversion Kors matrix, deviation time(SDAT) measured through Both SDAT are known markers dyssynchrony. Results 28 patients (17 male), age 67±7 yrs LBBAP. 21(75%) had for narrow 7(25%) LBBB. 17 (61%) LBB was achieved. The remaining treated QRS, both showed significant increase duration(p<0.001, p<0.001 resp.), without difference duration LBBP(fig. 1 A). There no compared reduction underlying LBBB (p=0.005, resp.) Furthermore, B). small but (p=0.011) where QRS. Compared (p=0.003, resp.). Moreover, when achieved over LVSP(p=0.044) (fig. C). Conclusion similar effect synchrony terms SDAT, levels comparable normal physiologic activation. resulted small, improvement Fig. Relative changes duration(A), (B) (C) (bradypacing) *p<0.05 baseline, **p<0.05 bradypacing combined.