ArticleJournal of cardiovascular electrophysiology2025
Comparison of Clinical Outcomes Between Left Bundle Branch Area Pacing With a Stylet-Driven Lead and Conventional Right Ventricular Pacing.
Article in Journal of cardiovascular electrophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.
What it found
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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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Clinical and electrical outcomes of conduction system pacing versus right ventricular pacing in atrioventricular block: a systematic review and meta-analysis.BMC cardiovascular disorders · 2026Pooled it
- Updated Meta-Analysis of Left Bundle Branch Area Pacing Versus Right Ventricular Pacing in Conduction System Disorders: Insights From New Evidence.Clinical cardiology · 2026Pooled it
- Feasibility and Safety on Left Bundle Branch Area Pacing With Standard Stylet-Driven Lead: ACHIEVE-SYNC Multicenter Prospective Observational Cohort Study.Journal of arrhythmia · 2026Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
BACKGROUNDS AND
aimsLeft bundle branch area pacing (LBBAP) has been shown to reduce the risk of pacing-facilitated heart failure (HF) compared to right ventricular pacing (RVP), but limited data exists comparing LBBAP with stylet-driven leads (SDL) and conventional RVP. The study aims to compare clinical outcomes between LBBAP using SDL and conventional RVP.
methodsFrom December 2018 to December 2023, patients who underwent pacemaker implantation at two tertiary hospitals were enrolled. Exclusions included those requiring cardiac resynchronization therapy and patients with ventricular pacing burden ≤ 10%. LBBAP was performed using SDL (Solia S60, Biotronik) with a fixed curve delivery sheath. Composite outcome I consisted of HF admission, pacing-induced cardiomyopathy (defined as an LVEF decline of ≥ 10% or below 50%), and upgrade to biventricular pacing. Composite outcome II included all-cause death in addition to the components of composite outcome I.
resultsA total of 738 patients (mean age 72.1 years; 52% of men; 243 LBBAP vs. 495 RVP) were included. Atrioventricular block was more common pacing indication in LBBAP group than RVP group (88.1% vs. 69.3%, p < 0.001). Compared to RVP group, ventricular pacing burden was higher in the LBBAP group (96% vs. 86%, p < 0.001). LBBAP was associated with a lower risk of composite outcome I and II compared to RVP (adjusted HR 0.27 [95% confidence interval 0.11-0.68], p = 0.006 for composite outcome I, aHR 0.41 [0.20-0.84], p = 0.015 for composite outcome II), mainly driven by a lower risk of pacing-induced cardiomyopathy by 70%. There were no significant differences in procedure-related complications.
conclusionLBBAP with SDL was associated with a lower risk of adverse clinical outcomes compared to conventional RVP in patients requiring substantial ventricular pacing.
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