{"title":"Stylet-Driven Lead Vs. Lumenless Lead for Left Bundle Branch Area Pacing: Systematic Literature Review and Meta-Analysis.","authors":"Ga-In Yu, Tae-Hoon Kim, Yun-Ho Cho, Jae-Seok Bae, Jong-Hwa Ahn, Jeong Yoon Jang, Choong Hwan Kwak","doi":"10.1111/pace.15209","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Left bundle branch area pacing (LBBAP) offers cardiac synchrony benefits over conventional ventricular pacing. Although many studies on LBBAP have used lumenless pacing leads (LLLs), stylet-driven pacing leads (SDLs) can also be used. In this study, we compared LLLs and SDLs for LBBAP through a systematic review and meta-analysis of the literature.</p><p><strong>Methods: </strong>The PubMed, Embase, and Cochrane Library databases were searched for full-text articles on LBBAP from their respective inception dates to April 9, 2024. The studies comparing LLLs and SDLs were extracted, and electrophysiological characteristics and procedural outcomes were analyzed. Of 2201 articles on LBBAP, 7 met the inclusion criteria of comparing LLLs and SDLs as implanted pacing leads.</p><p><strong>Results: </strong>The overall pooled analysis showed noninferiority in implant success rates for SDLs compared with LLLs for LBBAP (89% vs. 94%, odds ratio: 0.80, 95% confidence interval [CI]: 0.37-1.72, p = 0.566). The paced QRS duration of LBBAP using SDLs was not significantly different from that using LLLs (standardized mean difference: -0.19 ms, 95% CI: -0.50 to 0.12, p = 0.239). There were no differences in the stimulus to the left ventricular activation time and paced QRS duration between the two groups. Follow-up pacing parameters were stable in both groups.</p><p><strong>Conclusion: </strong>LBBAP using SDLs is noninferior to that using LLLs in terms of implantation success. There were no differences in procedural and electrophysiological characteristics between the two groups.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pace-Pacing and Clinical Electrophysiology","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1111/pace.15209","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Left bundle branch area pacing (LBBAP) offers cardiac synchrony benefits over conventional ventricular pacing. Although many studies on LBBAP have used lumenless pacing leads (LLLs), stylet-driven pacing leads (SDLs) can also be used. In this study, we compared LLLs and SDLs for LBBAP through a systematic review and meta-analysis of the literature.
Methods: The PubMed, Embase, and Cochrane Library databases were searched for full-text articles on LBBAP from their respective inception dates to April 9, 2024. The studies comparing LLLs and SDLs were extracted, and electrophysiological characteristics and procedural outcomes were analyzed. Of 2201 articles on LBBAP, 7 met the inclusion criteria of comparing LLLs and SDLs as implanted pacing leads.
Results: The overall pooled analysis showed noninferiority in implant success rates for SDLs compared with LLLs for LBBAP (89% vs. 94%, odds ratio: 0.80, 95% confidence interval [CI]: 0.37-1.72, p = 0.566). The paced QRS duration of LBBAP using SDLs was not significantly different from that using LLLs (standardized mean difference: -0.19 ms, 95% CI: -0.50 to 0.12, p = 0.239). There were no differences in the stimulus to the left ventricular activation time and paced QRS duration between the two groups. Follow-up pacing parameters were stable in both groups.
Conclusion: LBBAP using SDLs is noninferior to that using LLLs in terms of implantation success. There were no differences in procedural and electrophysiological characteristics between the two groups.
期刊介绍:
Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.