My preferred approach to left bundle branch pacing: Lumenless leads.

Abstract

Right ventricular (RV) pacing results in electromechanical dyssynchrony in the ventricles leading to increased risk for pacing induced cardiomyopathy, heart failure, atrial fibrillation and mortality. Physiologic pacing using His bundle pacing (HBP) or left bundle branch pacing(LBBP) maintains ventricular synchrony and in observational, case-control studies has been shown to reduce the risk for death, heart failure hospitalization or need for upgrade to biventricular pacing when compared to RV pacing1,2,3.