RESUMEN
BACKGROUND: Left bundle branch (LBB) pacing is a novel pacing technique which may serve as an alternative to both right ventricular pacing for symptomatic bradycardia and cardiac resynchronisation therapy (CRT). A substantial amount of data is reported by relatively few, highly experienced centres. This study describes the first experience of LBB pacing in a high-volume device centre. METHODS: Success rates (i.e. the ability to achieve LBB pacing), electrophysiological parameters and complications at implant and up to 6 months of follow-up were prospectively assessed in 100 consecutive patients referred for various pacing indications. RESULTS: The mean age was 71⯱ 11 years and 65% were male. Primary pacing indication was atrioventricular (AV) block in 40%, CRT in 42%, and sinus node dysfunction or refractory atrial fibrillation prior to AV node ablation in 9% each. Baseline left ventricular ejection fraction was <â¯50% in 57% of patients, mean baseline QRS duration 145⯱ 34â¯ms. Overall LBB pacing was successful in 83 of 100 (83%) patients but tended to be lower in patients with CRT pacing indication (69%, pâ¯= ns). Mean left ventricular activation time (LVAT) during LBB pacing was 81â¯ms and paced QRS duration was 120⯱ 19â¯ms. LBB capture threshold and Rwave sense at implant was 0.74⯱ 0.4â¯mV at 0.4â¯ms and 11.9⯱ 5.9â¯V and remained stable at 6month follow-up. No complications occurred during implant or follow-up. CONCLUSION: LBB pacing for bradycardia pacing and resynchronisation therapy can be easily adopted by experienced implanters, with favourable success rates and safety profile.