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June 27, 2026EP EuropaceOpen Access

Initial LVAT under ~97ms predicts successful LBB capture.

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Why the study?

Does initial LVAT predict successful left bundle branch capture in patients undergoing LBBP?

Population

192 patients undergoing left bundle branch pacing, mean age 74.3, 56.2% male. Pacing indications included…

Design

Cohort

Key result

An initial left ventricular activation time (LVAT) ≤ 96.5ms predicted successful final left bundle branch capture with 75.7% sensitivity and 63.5% specificity (AUC 0.73).

Authors

FYF YangSNS NgXTX Y Teoh

Discussion

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Overview

LBBP feasible in most cases; leaves open optimal selection criteria and long-term outcomes in prospective studies.

Key Points

  • The study aims to identify periprocedural implant parameters that predict successful left bundle branch capture in patients undergoing LBBP.
  • Analyzed 192 patients who underwent left bundle branch pacing.
  • Measured initial and final left ventricular activation time (LVAT) and QRS morphology.
  • Performed univariate and multivariate analyses using logistic regression and ROC curve analysis.
  • Successful left bundle branch pacing achieved in 72.9% of patients (23.4% selective, 76.6% non-selective).
  • Initial LVAT ≤ 96.5ms predicted successful final left bundle capture with 75.7% sensitivity and 63.5% specificity.
  • ROC analysis showed an area under the curve (AUC) of 0.73 for initial LVAT, outperforming the LVAT/QRS ratio.

Study Design

Type

Observational (n=192)

Structured PICO

Does initial LVAT predict successful left bundle branch capture in patients undergoing LBBP?

P
Population
192 patients (mean age 74.3, 43.8% female) undergoing left bundle branch pacing for indications including AV block and sick sinus syndrome.
E
Exposure
Measurement of initial left ventricular activation time (LVAT) prior to septal lead advancement during LBBP implantation
O
Outcome
Successful left bundle branch (LBB) capture (selective or non-selective, defined by LVAT ≤ 75ms in normal/RBBB or ≤ 85ms in LBBB, incomplete RBBB in V1, and V1–V6 inter-peak interval ≥ 33ms)surrogate

Main Result

Effect estimate: AUC 0.73

Limitations

  • Requires larger prospective studies to validate findings

Cite This Study

Yang et al. (2026) conducted an observational in Patients undergoing left bundle branch pacing (n=192). Initial left ventricular activation time (LVAT) was evaluated on Successful left bundle branch (LBB) capture (AUC 0.73). An initial left ventricular activation time (LVAT) ≤ 96.5ms predicted successful final left bundle branch capture with 75.7% sensitivity and 63.5% specificity (AUC 0.73).

synapsesocial.com/papers/6a3f9785125782b61d8657fahttps://doi.org/10.1093/europace/euag105.753
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Clinical Prediction Model for Unsuccessful Left Bundle Branch Area Pacing2026
  2. 2Long term efficacy and safety of left bundle branch pacing: an updated single center 4-year retrospective analysis2026
  3. 3Echocardiographic outcomes across different capture types in left bundle branch area pacing: a real-world cohort analysis2026
  4. 4Short‐ to Mid‐Term Efficacy and Safety of Left Bundle Branch Pacing Guided by Continuous Uninterrupted Paced Intracardiac Electrogram Monitoring Targeting Transition to Selective Left Bundle Branch Capture2025 · 1 citations
  5. 5LBBB is incomplete in the majority of patients with HF and LV systolic dysfunction submitted to conduction system pacing2026