Leadless Left Ventricular Endocardial Pacing and Left Bundle Branch Area Pacing for Cardiac Resynchronisation Therapy

Baldeep S Sidhu; Justin Gould; Mark K Elliott; Vishal Mehta; Steven Niederer; Christopher A Rinaldi

doi:10.15420/aer.2020.46

Leadless Left Ventricular Endocardial Pacing and Left Bundle Branch Area Pacing for Cardiac Resynchronisation Therapy

Arrhythm Electrophysiol Rev. 2021 Apr;10(1):45-50. doi: 10.15420/aer.2020.46.

Authors

Baldeep S Sidhu^{1

2}, Justin Gould^{1

2}, Mark K Elliott^{1

2}, Vishal Mehta^{1

2}, Steven Niederer¹, Christopher A Rinaldi^{1

2}

Affiliations

¹ School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.
² Guy's and St Thomas' Hospital, London, UK.

Abstract

Cardiac resynchronisation therapy is an important intervention to reduce mortality and morbidity, but even in carefully selected patients approximately 30% fail to improve. This has led to alternative pacing approaches to improve patient outcomes. Left ventricular (LV) endocardial pacing allows pacing at site-specific locations that enable the operator to avoid myocardial scar and target areas of latest activation. Left bundle branch area pacing (LBBAP) provides a more physiological activation pattern and may allow effective cardiac resynchronisation. This article discusses LV endocardial pacing in detail, including the indications, techniques and outcomes. It discusses LBBAP, its potential benefits over His bundle pacing and procedural outcomes. Finally, it concludes with the future role of endocardial pacing and LBBAP in heart failure patients.

Keywords: Cardiac resynchronisation therapy; WiSE-CRT; endocardial pacing; left bundle branch area pacing.

Publication types

Review