ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2023
Left bundle branch pacing with and without anodal capture: impact on ventricular activation pattern and acute haemodynamics.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- A systematic review and meta-analysis of the impact of left bundle branch area pacing on right ventricular function.Frontiers in cardiovascular medicine · 2025Pooled it
- Implantation Success, Electrical Performance, and Safety of an Active Fixation Stylet-Driven Lead for LBBAP in Clinical Practice: A Multicenter Experience.Journal of cardiovascular electrophysiology · 2026Article
- Comment on 'Cost-effective CRT using dual-chamber generators in patients without atrial pacing need'.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Mid- to long-term mechanical performance of left bundle branch area pacing: a comprehensive echocardiographic comparison of capture modalities.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Left bundle branch pacing in patients with structural heart disease: personalizing cardiac resynchronization therapy.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Review
- Lack of impact of baseline QRS morphology on the right heart during long-term left bundle branch pacing in patients with atrioventricular block.Heart rhythm O2 · 2025Article
- Physiological pacing: mechanisms, clinical indications, and perspectives.European heart journal · 2025Review
- Double QRS Transition Due to Anodal Capture During Left Bundle Branch Area Pacing: A Case Report.Journal of cardiovascular development and disease · 2025Article
- Multiple electrode leads facilitate left bundle branch area pacing: A concept evaluation study.Heart rhythm O2 · 2025Article
- Evaluation of cardiac energetics in left bundle branch area pacing using noninvasive pressure-volume loops.Heart rhythm O2 · 2025Article
- Evaluating electrical stability in left bundle branch area pacing for bradycardia patients at follow-up.Heart rhythm O2 · 2025Article
- Enhanced ventricular synchrony and myocardial function with bipolar left bundle area pacing: a comparative study of anodal ring capture versus unipolar pacing.European heart journal open · 2025Article
- European Society of Cardiology (ESC) clinical consensus statement on indications for conduction system pacing, with special contribution of the European Heart Rhythm Association of the ESC and endorsed by the Asia Pacific Heart Rhythm Society, the Canadian Heart Rhythm Society, the Heart Rhythm Society, and the Latin American Heart Rhythm Society.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Comparing the effects of left bundle branch pacing and leadless right ventricular pacing on intraventricular and interventricular dyssynchrony usingFrontiers in physiology · 2025Article
- Multicenter Hemodynamic Assessment of the LOT-CRT Strategy: When Does Combining Left Bundle Branch Pacing and Coronary Venous Pacing Enhance Resynchronization?: Primary Results of the CSPOT Study.Circulation. Arrhythmia and electrophysiology · 2024Article
- Successful management of complete heart block in checkpoint inhibitor induced myocarditis by left bundle branch area pacing: a case report.European heart journal. Case reports · 2024Article
Corrections and comments
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Authors and funding
21 authors at 4 institutions in 1 country.
Funding
Abstract
aimsLeft bundle branch pacing (LBBP) can deliver physiological left ventricular activation, but typically at the cost of delayed right ventricular (RV) activation. Right ventricular activation can be advanced through anodal capture, but there is uncertainty regarding the mechanism by which this is achieved, and it is not known whether this produces haemodynamic benefit. METHODS AND
resultsWe recruited patients with LBBP leads in whom anodal capture eliminated the terminal R-wave in lead V1. Ventricular activation pattern, timing, and high-precision acute haemodynamic response were studied during LBBP with and without anodal capture. We recruited 21 patients with a mean age of 67 years, of whom 14 were males. We measured electrocardiogram timings and haemodynamics in all patients, and in 16, we also performed non-invasive mapping. Ventricular epicardial propagation maps demonstrated that RV septal myocardial capture, rather than right bundle capture, was the mechanism for earlier RV activation. With anodal capture, QRS duration and total ventricular activation times were shorter (116 ± 12 vs. 129 ± 14 ms, P < 0.01 and 83 ± 18 vs. 90 ± 15 ms, P = 0.01). This required higher outputs (3.6 ± 1.9 vs. 0.6 ± 0.2 V, P < 0.01) but without additional haemodynamic benefit (mean difference -0.2 ± 3.8 mmHg compared with pacing without anodal capture, P = 0.2).
conclusionLeft bundle branch pacing with anodal capture advances RV activation by stimulating the RV septal myocardium. However, this requires higher outputs and does not improve acute haemodynamics. Aiming for anodal capture may therefore not be necessary.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.