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June 27, 2026EP EuropaceOpen Access

LBBAP maintains chronic activation of automated capture and sensing algorithms in ~94% of devices.

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Why the study?

Does left bundle branch area pacing with current pacemakers provide reliable pacing and sensing performance in real-world practice?

Population

2,894 patients with pacemaker devices connected to leads implanted in the left bundle branch area, including…

Design

Cohort

Follow-up

6 months

Key result

In 2,894 devices used for left bundle branch area pacing, ventricular AutoCapture, CapConfirm, and AutoSense remained chronically activated in 93.5%, 97.0%, and 96.5% of devices, respectively.

Authors

MSM SprowlsEJE JohnsonKRK Ryu

Discussion

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Overview

LBBA pacing burden varies by indication; hypothesis-generating for tailored programming but leaves open prospective validation.

Key Points

  • The study aims to analyze pacemaker performance and programming in patients undergoing left bundle branch area pacing implantation.
  • Retrospective analysis of data from pacemaker devices through September 2024 connected to leads implanted in the left bundle branch area.
  • Assessment of pacing capture threshold, sensed R-wave amplitude, and various programmable parameters in devices.
  • Follow-ups at 30 days, 3 months, and 6 months after implant.
  • Data analyzed from 2,894 devices, with predominance of Tendril STS 2088TC leads (77%).
  • Pacing output was ≤2.5V in 71% of devices with AutoCapture/CAPConfirm programmed off.
  • LBBA pacing burden was 76±37%, 63±42%, and 32±40% for AV block, atrial fibrillation, and sinus node dysfunction patients, respectively.

Study Design

Type

Observational (n=2,894)

Structured PICO

Does left bundle branch area pacing with current pacemakers provide reliable pacing and sensing performance in real-world practice?

P
Population
2,894 pacemaker devices connected to leads implanted in the left bundle branch area, analyzed retrospectively for pacing and sensing performance up to 6 months.
E
Exposure
Left bundle branch area pacing (LBBAP) using commercially available pacemakers and leads (predominantly Tendril STS 2088TC).
O
Outcome
Pacing capture threshold (PCT) and sensed R-wave amplitude (RWA) at initial (within 30 days), 3-month, and 6-month remote follow-ups.surrogate

Commercially available pacemakers demonstrate reliable chronic pacing and sensing performance when used for left bundle branch area pacing in real-world settings.

Cite This Study

Sprowls et al. (2026) conducted an observational in Pacemaker indication (AV block, atrial fibrillation, sinus node dysfunction) (n=2,894). Left bundle branch area pacing (LBBAP) was evaluated on Pacing capture threshold (PCT) and sensed R-wave amplitude (RWA). In 2,894 devices used for left bundle branch area pacing, ventricular AutoCapture, CapConfirm, and AutoSense remained chronically activated in 93.5%, 97.0%, and 96.5% of devices, respectively.

synapsesocial.com/papers/6a3f97bb125782b61d865992https://doi.org/10.1093/europace/euag105.729
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Also Consider

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

  1. 1Initial Experience With Implantation Left Bundle Branch Pacing Leads Without a Dedicated Three‐Dimensional Sheath2025
  2. 2Beyond QRS Narrowing: left bundle branch area pacing enhances ventricular synchrony and myocardial work2026
  3. 3Clinical outcomes of left bundle branch area pacing versus right ventricular pacing in patients with preserved ejection fraction2026
  4. 4Long term efficacy and safety of left bundle branch pacing: an updated single center 4-year retrospective analysis2026
  5. 5Safety profile of left bundle branch area pacing compared with other pacing modalities: acute and long-term outcomes2026