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Leadless left ventricular endocardial pacing and left bundle branch area pacing for cardiac resynchronisation therapy

Research output: Contribution to journalArticlepeer-review

Baldeep S. Sidhu, Justin Gould, Mark K. Elliott, Vishal Mehta, Steven Niederer, Christopher A. Rinaldi

Original languageEnglish
Pages (from-to)45-50
Number of pages6
JournalArrhythmia and Electrophysiology Review
Issue number1
PublishedMar 2021

Bibliographical note

Funding Information: Disclosure: BSS is funded by NIHR and received speaker fees from EBR Systems outside of the submitted work. JG has received project funding from Rosetrees Trust outside of the submitted work. JG, MKE and VM have received fellowship funding from Abbott outside of the submitted work. CAR receives research funding and/ or consultation fees from Abbott, Medtronic, Boston Scientific and MicroPort outside of the submitted work. SN has no conflicts of interest to declare. The study was supported by the Wellcome/EPSRC Centre for Medical Engineering (WT203148/Z/16/Z). Acknowledgement: The authors thank Michael Lee and EBR Systems for providing images used in this manuscript. Received: 5 December 2020 Accepted: 31 December 2020 Citation: Arrhythmia & Electrophysiology Review 2021;10(1):45–50. DOI: Correspondence: Baldeep Singh Sidhu, School of Biomedical Engineering and Imaging Sciences, St Thomas’ Hospital, London SE1 7EH, UK. E: Open Access: This work is open access under the CC-BY-NC 4.0 License which allows users to copy, redistribute and make derivative works for non-commercial purposes, provided the original work is cited correctly. Publisher Copyright: © RADCLIFFE CARDIOLOGY 2021. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Cardiac resynchronisation therapy is an important intervention to reduce mortality and morbidity, but even in carefully selected patients approximately 30% fail to improve. This has led to alternative pacing approaches to improve patient outcomes. Left ventricular (LV) endocardial pacing allows pacing at site-specific locations that enable the operator to avoid myocardial scar and target areas of latest activation. Left bundle branch area pacing (LBBAP) provides a more physiological activation pattern and may allow effective cardiac resynchronisation. This article discusses LV endocardial pacing in detail, including the indications, techniques and outcomes. It discusses LBBAP, its potential benefits over His bundle pacing and procedural outcomes. Finally, it concludes with the future role of endocardial pacing and LBBAP in heart failure patients.

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