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Leadless Left Bundle Branch Area Pacing in Cardiac Resynchronisation Therapy: Advances, Challenges and Future Directions

Leadless left bundle branch area pacing (LBBAP) represents the merger of two rapidly progressing areas in the field of cardiac resynchronisation therapy (CRT). It combines the attractive concepts of pacing the native conduction system to allow more physiological activation of the myocardium than con...

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Autores principales: Wijesuriya, Nadeev, Elliott, Mark K., Mehta, Vishal, Sidhu, Baldeep S., Strocchi, Marina, Behar, Jonathan M., Niederer, Steven, Rinaldi, Christopher A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9208327/
https://www.ncbi.nlm.nih.gov/pubmed/35733988
http://dx.doi.org/10.3389/fphys.2022.898866
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author Wijesuriya, Nadeev
Elliott, Mark K.
Mehta, Vishal
Sidhu, Baldeep S.
Strocchi, Marina
Behar, Jonathan M.
Niederer, Steven
Rinaldi, Christopher A.
author_facet Wijesuriya, Nadeev
Elliott, Mark K.
Mehta, Vishal
Sidhu, Baldeep S.
Strocchi, Marina
Behar, Jonathan M.
Niederer, Steven
Rinaldi, Christopher A.
author_sort Wijesuriya, Nadeev
collection PubMed
description Leadless left bundle branch area pacing (LBBAP) represents the merger of two rapidly progressing areas in the field of cardiac resynchronisation therapy (CRT). It combines the attractive concepts of pacing the native conduction system to allow more physiological activation of the myocardium than conventional biventricular pacing, with the potential added benefits of avoiding long-term complications associated with transvenous leads via leadless left ventricular endocardial pacing. This perspective article will first review the evidence for the efficacy of leadless pacing in CRT. We then summarise the procedural steps and pilot data for leadless LBBAP, followed by a discussion of the safety and efficacy of this novel technique. Finally, we will examine how further mechanistic evidence may shed light to which patients may benefit most from leadless LBBAP, and how improvements in current experience and technology could promote widespread uptake and expand current clinical indications.
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spelling pubmed-92083272022-06-21 Leadless Left Bundle Branch Area Pacing in Cardiac Resynchronisation Therapy: Advances, Challenges and Future Directions Wijesuriya, Nadeev Elliott, Mark K. Mehta, Vishal Sidhu, Baldeep S. Strocchi, Marina Behar, Jonathan M. Niederer, Steven Rinaldi, Christopher A. Front Physiol Physiology Leadless left bundle branch area pacing (LBBAP) represents the merger of two rapidly progressing areas in the field of cardiac resynchronisation therapy (CRT). It combines the attractive concepts of pacing the native conduction system to allow more physiological activation of the myocardium than conventional biventricular pacing, with the potential added benefits of avoiding long-term complications associated with transvenous leads via leadless left ventricular endocardial pacing. This perspective article will first review the evidence for the efficacy of leadless pacing in CRT. We then summarise the procedural steps and pilot data for leadless LBBAP, followed by a discussion of the safety and efficacy of this novel technique. Finally, we will examine how further mechanistic evidence may shed light to which patients may benefit most from leadless LBBAP, and how improvements in current experience and technology could promote widespread uptake and expand current clinical indications. Frontiers Media S.A. 2022-06-06 /pmc/articles/PMC9208327/ /pubmed/35733988 http://dx.doi.org/10.3389/fphys.2022.898866 Text en Copyright © 2022 Wijesuriya, Elliott, Mehta, Sidhu, Strocchi, Behar, Niederer and Rinaldi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Wijesuriya, Nadeev
Elliott, Mark K.
Mehta, Vishal
Sidhu, Baldeep S.
Strocchi, Marina
Behar, Jonathan M.
Niederer, Steven
Rinaldi, Christopher A.
Leadless Left Bundle Branch Area Pacing in Cardiac Resynchronisation Therapy: Advances, Challenges and Future Directions
title Leadless Left Bundle Branch Area Pacing in Cardiac Resynchronisation Therapy: Advances, Challenges and Future Directions
title_full Leadless Left Bundle Branch Area Pacing in Cardiac Resynchronisation Therapy: Advances, Challenges and Future Directions
title_fullStr Leadless Left Bundle Branch Area Pacing in Cardiac Resynchronisation Therapy: Advances, Challenges and Future Directions
title_full_unstemmed Leadless Left Bundle Branch Area Pacing in Cardiac Resynchronisation Therapy: Advances, Challenges and Future Directions
title_short Leadless Left Bundle Branch Area Pacing in Cardiac Resynchronisation Therapy: Advances, Challenges and Future Directions
title_sort leadless left bundle branch area pacing in cardiac resynchronisation therapy: advances, challenges and future directions
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9208327/
https://www.ncbi.nlm.nih.gov/pubmed/35733988
http://dx.doi.org/10.3389/fphys.2022.898866
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