Caruzzo CA, Rigamonti E, Scopigni FR. Left bundle branch area pacing: A new era of cardiac resynchronization therapy? World J Cardiol 2024; 16(9): 542-545 [PMID: 39351338 DOI: 10.4330/wjc.v16.i9.542]
Corresponding Author of This Article
Carlo Alberto Caruzzo, MD, Doctor, Department of Cardiologia, Istituto Cardiocentro del Ticino, Via Tesserete, Lugano 6900, TI, Switzerland. carloalberto.caruzzo@gmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Sep 26, 2024; 16(9): 542-545 Published online Sep 26, 2024. doi: 10.4330/wjc.v16.i9.542
Left bundle branch area pacing: A new era of cardiac resynchronization therapy?
Carlo Alberto Caruzzo, Elia Rigamonti, Francesca Romana Scopigni
Carlo Alberto Caruzzo, Elia Rigamonti, Francesca Romana Scopigni, Department of Cardiology, Istituto Cardiocentro del Ticino, Lugano 6900, TI, Switzerland
Co-corresponding authors: Carlo Alberto Caruzzo and Elia Rigamonti.
Author contributions: Caruzzo CA wrote the original draft; Rigamonti E contributed to conceptualization, writing, reviewing, editing, and received the original invitation to write the editorial; Scopigni FR participated in drafting the manuscript and critically revised its content; Caruzzo CA and Rigamonti E collaborated equally on the paper and their joint efforts in pre-publication administrative, intellectual and supervisory activities were crucial in generation and publication of the final letter; all authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Carlo Alberto Caruzzo, MD, Doctor, Department of Cardiologia, Istituto Cardiocentro del Ticino, Via Tesserete, Lugano 6900, TI, Switzerland. carloalberto.caruzzo@gmail.com
Received: June 16, 2024 Revised: July 30, 2024 Accepted: August 26, 2024 Published online: September 26, 2024 Processing time: 94 Days and 15.6 Hours
Abstract
The recent systematic review and meta-analysis provided a comprehensive focus on the current state of cardiac resynchronization therapy (CRT). The authors determined the feasibility of physiological left bundle branch area pacing (LBBAP) in patients indicated for CRT through a careful analysis of trials. They found that LBBAP was associated with significant reductions in QRS duration, New York Heart Association functional class, B-type natriuretic peptide levels, and pacing thresholds as well as improvements in echocardiographic parameters compared to biventricular pacing.
Core Tip: In heart failure, conduction defects, such as left bundle branch block, are common and result in regionally delayed electrical activation. Traditional pacing modalities, such as biventricular pacing, are non-physiological and directly stimulate the common myocardium, which may limit the clinical response. Left bundle branch area pacing bypasses the pathological region of the cardiac conduction system and leads to near-physiological or true conduction system pacing for patients needing ventricular pacing for bradycardia or heart failure. There is increasing interest in physiological pacing techniques that can directly activate the specialized conduction system.
