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Conventional biventricular pacing remains the recommended therapy for heart failure patients. However, due to anatomical factors and the complex distribution of conduction system disease, the success rate of left bundle branch area pacing (LBBAP) is lower in this population (Jastrzębski et al. Eur Heart J. 43:4161–4173, 2022). Nevertheless, with appropriate patient selection and structured approach to pre-implant, intraprocedural, and post-implant assessment, conduction system pacing offers a more physiological method of restoring electrical and mechanical synchrony (Joza et al. EP Europace 27(10):euaf154, 2025). This chapter reports a case of successfull left bundle branch pacing implantation in a patient with ischemic heart disease, reduced ejection fraction, bradyarrhythmic syncope, and baseline left bundle branch block, illustrating its role as an alternative cardiac resynchronization strategy in selected patients.

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LBBAP as Cardiac Resynchronization Strategy

  • 章节

  • 发表日期：

    2026年

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  • Francesco Deluca

摘要

Conventional biventricular pacing remains the recommended therapy for heart failure patients. However, due to anatomical factors and the complex distribution of conduction system disease, the success rate of left bundle branch area pacing (LBBAP) is lower in this population (Jastrzębski et al. Eur Heart J. 43:4161–4173, 2022). Nevertheless, with appropriate patient selection and structured approach to pre-implant, intraprocedural, and post-implant assessment, conduction system pacing offers a more physiological method of restoring electrical and mechanical synchrony (Joza et al. EP Europace 27(10):euaf154, 2025). This chapter reports a case of successfull left bundle branch pacing implantation in a patient with ischemic heart disease, reduced ejection fraction, bradyarrhythmic syncope, and baseline left bundle branch block, illustrating its role as an alternative cardiac resynchronization strategy in selected patients.