Left ventricular resynchronization with left bundle branch area pacing: does the type of capture matter?

Abstract

Cardiac resynchronization therapy (CRT) with biventricular pacing (BiV) has been a mainstream treatment in heart failure patients with wide QRS complexes for two decades. In recent years, left bundle branch pacing (LBBP) and left septal myocardial pacing (LVSP) appeared as two novel CRT strategies. During LBBP, there is direct left bundle branch (LBB) capture, while during LVSP, myocytes of the left septum are captured first, and the left ventricular (LV) conduction system is activated with some latency. The common term left bundle branch area pacing (LBBAP) is used to reflect the deep septal deployment of the pacing lead with direct or indirect capture of the LBB fibres.