Article: A Study to Analyse the Feasibility and Effectiveness of Left Bundle Branch Area Pacing Used in Young Children

This study aimed to investigate the feasibility and effectiveness of left bundle branch area pacing (LBBaP) in young children. From September 2020 to May 2021, a total of 31 children (≤ 7 years) with complete atrioventricular block were included. All patients were scheduled to undergo LBBaP. Pacing parameters, and cardiac function and synchrony were evaluated during follow-up. LBBaP succeeded in 21 children (3.3 ± 2.1 years old), with a success rate of 70.9%. LBBaP failed in nine children, who eventually received right ventricular septal pacing (RVSP). The average postoperative QRS duration in patients of LBBaP group was narrower than that of RVSP group: 100.9 ± 9.1 versus 114.2 ± 11.9 ms (P = 0.002). The median follow-up duration was 12 [interquartile range (IQR) 6-15] months. At last time of follow-up, the capture threshold of ventricular electrode in patients of LBBaP group were significantly lower than that of RVSP group (0.70 ± 0.25 versus 1.39 ± 0.94 V, P = 0.011). The echo-left ventricular ejection fraction (LVEF) in patients in the LBBaP group was better than that in the RVSP group (66.1 ± 3.3 versus 63.1 ± 2.2%, P = 0.025). LBBaP can be safely and effectively administered in young children. Satisfactory pacing parameters, and narrow QRS durations were obtained.

Citing Articles

Left bundle branch area pacing in children: case series.

Jedrzejczyk-Patej E, Mazurek M, Kowalski O, Szulik M, Tyc F, Pietruczuk A Eur Heart J Case Rep. 2025; 9(2):ytaf020.

PMID: 39935814 PMC: 11811521. DOI: 10.1093/ehjcr/ytaf020.

Left Bundle Branch Pacing in a Pediatric Patient With Tricuspid Valve Replacement for a Complex Ebstein Anomaly.

Tian D, Jiang L, Shen J Ann Noninvasive Electrocardiol. 2025; 30(2):e70057.

PMID: 39932104 PMC: 11811882. DOI: 10.1111/anec.70057.

References

1.

Siu C, Wang M, Zhang X, Lau C, Tse H . Analysis of ventricular performance as a function of pacing site and mode. Prog Cardiovasc Dis. 2008; 51(2):171-82. DOI: 10.1016/j.pcad.2008.01.001. View

2.

Gebauer R, Tomek V, Salameh A, Marek J, Chaloupecky V, Gebauer R . Predictors of left ventricular remodelling and failure in right ventricular pacing in the young. Eur Heart J. 2009; 30(9):1097-104. PMC: 2675702. DOI: 10.1093/eurheartj/ehp060. View

3.

Safak E, Ince H, Gkouvatsou L, Schultheiss H, Ortak J, Caglayan E . Pacing-induced cardiomyopathy in chronic right ventricular apical pacing: a midterm follow-up study. Eur J Med Res. 2019; 24(1):23. PMC: 6643303. DOI: 10.1186/s40001-019-0386-5. View

4.

Li X, Qiu C, Xie R, Ma W, Wang Z, Li H . Left bundle branch area pacing delivery of cardiac resynchronization therapy and comparison with biventricular pacing. ESC Heart Fail. 2020; 7(4):1711-1722. PMC: 7373885. DOI: 10.1002/ehf2.12731. View

5.

Vijayaraman P, Subzposh F, Naperkowski A, Panikkath R, John K, Mascarenhas V . Prospective evaluation of feasibility and electrophysiologic and echocardiographic characteristics of left bundle branch area pacing. Heart Rhythm. 2019; 16(12):1774-1782. DOI: 10.1016/j.hrthm.2019.05.011. View

6.

Shah M, Silka M, Avari Silva J, Balaji S, Beach C, Benjamin M . 2021 PACES expert consensus statement on the indications and management of cardiovascular implantable electronic devices in pediatric patients. Indian Pacing Electrophysiol J. 2021; 21(6):367-393. PMC: 8577100. DOI: 10.1016/j.ipej.2021.07.005. View

7.

Zhang J, Wang Z, Cheng L, Zu L, Liang Z, Hang F . Immediate clinical outcomes of left bundle branch area pacing vs conventional right ventricular pacing. Clin Cardiol. 2019; 42(8):768-773. PMC: 6671779. DOI: 10.1002/clc.23215. View

8.

Zhang S, Zhou X, Gold M . Left Bundle Branch Pacing: JACC Review Topic of the Week. J Am Coll Cardiol. 2019; 74(24):3039-3049. DOI: 10.1016/j.jacc.2019.10.039. View

9.

Jimenez E, Zaban N, Sharma N, Narasimhan S, Martin-Chafee C, Lohr J . His Bundle and Left Bundle Pacing in Pediatrics and Congenital Heart Disease: A Single Center Experience. Pediatr Cardiol. 2020; 41(7):1425-1431. DOI: 10.1007/s00246-020-02398-9. View

10.

Jiang H, Hou X, Qian Z, Wang Y, Tang L, Qiu Y . A novel 9-partition method using fluoroscopic images for guiding left bundle branch pacing. Heart Rhythm. 2020; 17(10):1759-1767. DOI: 10.1016/j.hrthm.2020.05.018. View

11.

Abdelrahman M, Subzposh F, Beer D, Durr B, Naperkowski A, Sun H . Clinical Outcomes of His Bundle Pacing Compared to Right Ventricular Pacing. J Am Coll Cardiol. 2018; 71(20):2319-2330. DOI: 10.1016/j.jacc.2018.02.048. View