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June 27, 2026EP EuropaceOpen Access

LBBP fails to reduce QRS duration at 4 years in patients with pre-existing LBBB.

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Why the study?

Does left bundle branch pacing maintain long-term efficacy and safety in patients requiring pacing?

Population

271 patients who underwent left bundle branch pacing with adequate follow-up data, mean age 76 years, 39%…

Design

Cohort

Follow-up

up to 4 years

Key result

Left bundle branch pacing did not significantly decrease mean QRS duration at 4 years in patients with pre-existing LBBB (136.36 ms vs 148.60 ms at baseline; p=0.25).

Authors

PMP MahajanDPD ParfianowiczBSB Shrestha

Discussion

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Overview

Stable LBBP thresholds with no revisions at 4 years support durability; extends observational data but leaves open need for prospective confirmation.

Key Points

  • This research aims to assess the long-term efficacy and safety of left bundle branch pacing in patients.
  • Data collected from 271 patients who underwent left bundle branch pacing between January 2019 and November 2023.
  • Included pre-implantation and follow-up ECG, device interrogation, and echocardiograms.
  • Data analyzed using regression analysis and paired t-test.
  • Mean QRS duration showed a non-significant decrease after LBBP, with p = 0.35 at implantation.
  • Mean left ventricular ejection fraction (LVEF) remained statistically unchanged at all follow-ups post-implantation.
  • Only 2 patients had a capture threshold >2 V at 4 years, with no lead revisions required.

Study Design

Type

Cohort (n=271)

Multicenter

No

Structured PICO

Does left bundle branch pacing maintain long-term efficacy and safety in patients requiring pacing?

P
Population
271 patients (mean age 76 years, 39% female) who underwent left bundle branch pacing and had adequate follow-up data, evaluated retrospectively over 4 years.
E
Exposure
Left bundle branch pacing (LBBP) with selective LBB capture
O
Outcome
Long term efficacy and safety (including QRS duration, LVEF, capture threshold, and complications) up to 4 yearssurrogate

Main Result

Absolute Event Rate: 136.36% vs 148.6%

p-value: p=0.25

Left bundle branch pacing is a reliable physiologic pacing technique with stable long-term capture thresholds and minimal complications over 4 years.

Limitations

  • single center
  • retrospective analysis

Cite This Study

Mahajan et al. (2026) conducted a cohort in Patients requiring pacing (n=271). Left bundle branch pacing (LBBP) vs. Baseline (pre-implantation) was evaluated on Mean QRS duration at 4 years in patients with pre-existing LBBB (p=0.25). Left bundle branch pacing did not significantly decrease mean QRS duration at 4 years in patients with pre-existing LBBB (136.36 ms vs 148.60 ms at baseline; p=0.25).

synapsesocial.com/papers/6a3f97e8125782b61d865af8https://doi.org/10.1093/europace/euag105.709
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Also Consider

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

  1. 1Short‐ 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
  2. 2Left Bundle Branch Pacing Facilitated by Novel Surface Electrocardiography in Comparison with Electrophysiology Recording System2025
  3. 3Left bundle branch pacing after transcatheter aortic valve implantation: a retrospective study on feasibility, electrical stability, and short-term outcomes2026
  4. 4Periprocedural implant predictors for successful left bundle branch pacing2026
  5. 5Safety profile of left bundle branch area pacing compared with other pacing modalities: acute and long-term outcomes2026