Observational studyJournal of cardiovascular electrophysiology2026
Impact of Left Bundle Branch Pacing on Left Ventricular Mechanical Efficiency.
Observational study in Journal of cardiovascular electrophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06324682 (Evaluation of conTempoRary Cardiac Stimulation in Clinical practicE), which is not on this map. Not yet cited in PubMed.
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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
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Evaluation of conTempoRary Cardiac Stimulation in Clinical practicE: lEft, BivEntriculAr, Right, and conDuction System Pacing
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Authors and funding
11 authors.
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Abstract
backgroundLeft bundle branch pacing (LBBP) restores physiological ventricular activation, yet its impact on left ventricular (LV) mechanical efficiency remains incompletely understood.
objectiveTo compare LV mechanical efficiency during spontaneous rhythm and LBBP using myocardial work (MW) indices, and to evaluate the influence of QRS transition type.
methodsIn 115 patients enrolled in the prospective TREEBEARD study (NCT06324682), MW indices (i.e., global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE)) were measured before and after LBBP. Patients were classified according to QRS transition during decremental output as Left Bundle (LB) group (nonselective to selective LBB capture) or non-LB group (nonselective capture to LV septal pacing).
resultsOverall, LBBP achieved mechanical efficiency comparable to that observed during spontaneous rhythm. In the LB group, all MW indices showed strong correlations between spontaneous rhythm and LBBP. In the non-LB group, GWI (r = 0.685, p < 0.001) and GCW (r = 0.750, p < 0.001) remained strongly correlated, whereas GWE (r = 0.4224, p = 0.01) and GWW (r = 0.395, p = 0.002) showed moderate and weak correlations, respectively.
conclusionBased on our findings, LBBP appears to preserve LV mechanical efficiency to a degree comparable to spontaneous rhythm. Direct engagement of the conduction system, reflected by a nonselective to selective LBBP QRS transition, is associated with greater concordance of MW indices.
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