The Emerging Role of Left Bundle Branch Area Pacing for Cardiac Resynchronisation Therapy

Juan Carlos Diaz, Mauricio Duque, Julian Aristizabal, Jorge Marin, Cesar Niño, Oriana Bastidas, Luis Miguel Ruiz, Carlos D. Matos, Carolina Hoyos, Daniela Hincapie, Alejandro Velasco, Jorge E. Romero

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Cardiac resynchronisation therapy (CRT) reduces the risk of heart failure-related hospitalisations and all-cause mortality, as well as improving quality of life and functional status in patients with persistent heart failure symptoms despite optimal medical treatment and left bundle branch block. CRT has traditionally been delivered by implanting a lead through the coronary sinus to capture the left ventricular epicardium; however, this approach is associated with significant drawbacks, including a high rate of procedural failure, phrenic nerve stimulation, high pacing thresholds and lead dislodgement. Moreover, a significant proportion of patients fail to derive any significant benefit. Left bundle branch area pacing (LBBAP) has recently emerged as a suitable alternative to traditional CRT. By stimulating the cardiac conduction system physiologically, LBBAP can result in a more homogeneous left ventricular contraction and relaxation, thus having the potential to improve outcomes compared with conventional CRT strategies. In this article, the evidence supporting the use of LBBAP in patients with heart failure is reviewed.

Original languageEnglish (US)
JournalArrhythmia and Electrophysiology Review
StatePublished - 2023


  • Heart failure
  • cardiac resynchronisation therapy
  • conduction system pacing
  • heart failure-related hospitalisation
  • left bundle branch area pacing

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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