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Review
. 2020 Sep;31(9):2462-2473.
doi: 10.1111/jce.14681. Epub 2020 Jul 30.

Left bundle branch pacing: A comprehensive review

Shunmuga Sundaram Ponnusamy  1 , Vanita Arora  2 , Narayanan Namboodiri  3 , Vivek Kumar  2 , Aditya Kapoor  4 , Pugazhendhi Vijayaraman  5
Affiliations
Review

Left bundle branch pacing: A comprehensive review

Shunmuga Sundaram Ponnusamy et al. J Cardiovasc Electrophysiol. 2020 Sep.

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.

Keywords: conduction system; dyssynchrony; heart failure; left bundle pacing; physiological pacing.

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References

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