Assessment of Clinical Outcomes and Electrophysiological Parameters of Left Bundle Branch Area Pacing: A Single-center Prospective Study with 12-month Follow-up

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Background: Left bundle branch pacing (LBBP) is developing as an effective technique for cardiac pacing, offering potential advantages over traditional right ventricular pacing methods. However, comprehensive assessment of LBBP outcomes across various indications and over extended follow-up periods is limited. This single-center prospective study aims to address this gap by evaluating the electrophysiological, echocardiographic, and clinical outcomes of LBBP over a 12-month follow-up period. Methods: This was a single-center prospective cohort study with repeated follow-up assessments performed at 3, 6, and 12 months following left bundle branch area pacing (LBBAP) implantation. This study enrolled 63 patients aged 18-80 with symptomatic bradyarrhythmia and left ventricular dysfunction undergoing LBBAP using Select Secure pacing leads. Outcomes were compared pre- and post-implantation at 3-, 6-, and 12-month follow-up, assessing electrophysiological parameters, cardiac function, and adverse events. Results: In this study, successful implantation was achieved in all patients, with selective LBB capture demonstrated in 78.9%. Lead parameters such as capture threshold, paced QRS duration, pacing impedance, and R wave amplitude at 3, 6, and 12 months when compared with the baseline, remained stable with no significant changes over time. Individuals with lower baseline ejection fraction EF improved significantly from baseline between 3 and 6 months, 6 and 12 months, and 3 and 12 months, respectively. Procedural and late complications were minimal. Conclusion: With improvements observed in electrophysiological parameters, cardiac function, and minimal adverse events over a 12-month follow-up period, LBBP demonstrates both efficacy and safety in this patient population. These results advocate for further exploration and utilization of LBBP as a preferred pacing strategy in clinical practice.

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