Outcomes of Left Bundle Branch Area Pacing in Heart Failure Patients: A Systematic Review

IF 0.9 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology Pub Date : 2026-02-02 DOI:10.1111/anec.70158

Hina Ahmed Siddiqui, Mounika Kotte, Hilana Soliman Omar, Saad Manzoor, Zohaib Qasim, Fnu Abdullah, Sadia Siddique, Muhammad Bari Hassan, Ali Karim, Hansa Devi, Ekta Rani, Aniket Tara, Payal Bai, Sajid Ali, Hina Kumari, Sitara Jabeen, Vikram Kumar, Abida Perveen

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Abstract

Background

Left bundle branch area pacing (LBBAP) is an emerging physiological pacing technique that restores ventricular electrical synchrony by directly engaging the left conduction system. It has been proposed as an alternative to conventional pacing strategies, particularly in heart failure patients with reduced left ventricular ejection fraction (LVEF ≤ 50%).

Methods

A systematic literature search of PubMed, MEDLINE, and Scopus was conducted up to December 2024 in accordance with PRISMA guidelines. Sixteen studies involving 5680 patients were included. Reported outcomes included changes in LVEF, QRS duration (QRSd), hospitalization rates, complications, and mortality. Due to heterogeneity among studies, a qualitative narrative synthesis was performed.

Results

LBBAP was associated with significant improvements in cardiac function, with most studies reporting increased LVEF and marked reductions in QRSd, indicating improved electrical synchrony. Complication rates were low, with rare events such as pneumothorax and lead dislodgement. Heart failure–related hospitalizations were lower with LBBAP compared with biventricular pacing (19.05% vs. 30.00%), while mortality rates remained low across pacing strategies. Overall, LBBAP demonstrated superior electrical resynchronization and favorable clinical outcomes compared with conventional pacing modalities.

Conclusion

LBBAP is a promising pacing strategy that improves electrical synchrony and cardiac function with a favorable short- to mid-term safety profile. Further large-scale randomized studies are needed to establish its long-term efficacy and safety.

Abstract Image

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心力衰竭患者左束支区起搏的结果：系统回顾。

背景：左束分支区起搏（LBBAP）是一种新兴的生理起搏技术，通过直接参与左传导系统来恢复心室电同步。它已被提议作为传统起搏策略的替代方案，特别是在左心室射血分数降低（LVEF≤50%）的心力衰竭患者中。方法：根据PRISMA指南，系统检索PubMed、MEDLINE和Scopus的文献，检索时间截止到2024年12月。纳入16项研究，涉及5680例患者。报告的结果包括LVEF、QRS持续时间（QRSd）、住院率、并发症和死亡率的变化。由于研究的异质性，我们进行了定性的叙事综合。结果：LBBAP与心功能的显著改善相关，大多数研究报告LVEF增加，QRSd显著降低，表明电同步性改善。并发症发生率低，气胸和铅脱位等罕见事件。与双心室起搏相比，LBBAP与心力衰竭相关的住院率较低（19.05%对30.00%），而起搏策略的死亡率仍然较低。总体而言，与传统起搏方式相比，LBBAP表现出优越的电再同步和良好的临床结果。结论：LBBAP是一种有前景的起搏策略，可改善电同步性和心功能，并具有良好的中短期安全性。需要进一步的大规模随机研究来确定其长期有效性和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.