Technical feasibility of leadless left bundle branch area pacing for cardiac resynchronization: A case series

Mark K. Elliott*, Peggy Jacon, Baldeep Singh Sidhu, Lucy Jarrett Smith, Vishal S. Mehta, Justin Gould, Angela W.C. Lee, Steven Niederer, Pascal Defaye, Christopher A. Rinaldi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Background: Left bundle branch area pacing (LBBAP) is a novel form of conduction system pacing which can reverse left bundle branch block and deliver cardiac resynchronization therapy (CRT). The WiSE-CRT system delivers leadless endocardial pacing with symptomatic and left ventricular (LV) remodelling improvements following intervention. We report the technical feasibility of delivering leadless LBBAP using the WiSE-CRT system. Case summary: In Case 1, a 57-year-old male with ischaemic cardiomyopathy and complete heart block underwent implantation of the WiSE-CRT system, using a retrograde transaortic approach, after failed conventional CRT. Temporary left bundle stimulation from the LV septum achieved superior electrical resynchronization and equivalent haemodynamic response compared to endocardial pacing at the lateral LV wall. In Case 2, an 82-year-old gentleman with tachyarrhythmia-induced cardiomyopathy underwent WiSE-CRT implantation via a trans-septal inter-atrial approach, with the endocardial electrode successfully deployed in the LV septum. Discussion: Here we report the first case of deployment of the WiSE-CRT endocardial electrode in the LV septum and demonstrate the technical feasibility of leadless LBBAP. Entirely leadless CRT is an attractive option for patients with venous access issues or recurrent lead complications and has previously been successful using the WiSE-CRT system and a leadless pacemaker in the right ventricle. Further studies are required to assess long-term efficacy and safety of leadless LBBAP.

Original languageEnglish
Article numberytab379
JournalEuropean Heart Journal - Case Reports
Issue number11
Publication statusPublished - 1 Nov 2021


  • Cardiac resynchronization therapy
  • Case series
  • Endocardial pacing
  • Heart failure
  • Leadless pacing
  • Left bundle branch area pacing


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