Left Bundle Branch Area Pacing

Contents. #Introduction · #Definition · #Evidence and Outcomes · #Implantation Technique · #Capture Criteria · #Rationale and Electrophysiology · #Contradictions / Open Questions · #Sources

Detailed pages. concepts/LBBAP-Capture-Criteria · concepts/LBBAP-Implantation-Technique · concepts/LBBAP-Outcomes

Introduction

LBBAP is a physiological pacing strategy that places the lead on the left side of the interventricular septum. The rationale, evidence and main uncertainty can be summarised in brief.

• LBBAP is capture of the left side of the interventricular septum, with or without conduction-system capture. It is an umbrella term for LBBP, LFP and LVSP.
• In MELOS (n=2,533), 69.5% of implants were fascicular pacing, 21.5% were LVSP and only 9% were proximal LBBP — so more than one in five implants were LVSP, with septal myocardial capture but no conduction-system capture. (sources/melos-lbbap-ehj-2022, rating: high)
• It exists because His bundle pacing fails at the block and biventricular pacing leaves non-responders; pacing distal to the block is the structural answer.
• Large cohorts show less heart failure hospitalisation than BVP but no adjusted mortality difference; the first randomised trial, LEFT-BUNDLE-CRT, did not meet its intention-to-treat non-inferiority margin. (sources/left-bundle-crt-ehj-2026, rating: high)
• Capture is proven by an output-dependent QRS transition when one exists — but that is only ~26% of cases; every other criterion is a surrogate. (sources/melos-lbbap-ehj-2022, rating: high)
• The main unresolved question is whether conduction-system capture itself is necessary, or whether LVSP achieves the same clinical benefit.

Abbreviations. LBBAP = left bundle branch area pacing; LBBP = left bundle branch pacing; LFP = left fascicular pacing; LVSP = left ventricular septal pacing; S-/NS- = selective/nonselective; LVAT = left ventricular activation time; V6RWPT = stimulus-to-V6-R-wave-peak time; COI = current of injury; SDL = stylet-driven lead; LLL = lumenless lead; BVP = biventricular pacing; HBP = His bundle pacing; HFH = heart failure hospitalisation.

Definition

Left bundle branch area pacing is capture of the subendocardial area on the left side of the interventricular septum, with or without simultaneous conduction-system capture. It is an umbrella term for left bundle branch pacing (LBBP), left fascicular pacing (LFP) and left ventricular septal pacing (LVSP), used when differentiation between the sub-types is impossible, uncertain or not feasible. (sources/csp-ehra-2023, rating: high)

The capture spectrum

(Table: sources/melos-lbbap-ehj-2022, rating: high)

LFP sub-types are named by frontal axis: LAFP with QRS positive in II and III; LSFP with II positive/isoelectric and III isoelectric/negative; LPFP with QRS negative in II and III. (sources/melos-lbbap-ehj-2022, rating: high)

Two distinctions matter clinically:

• Selective versus nonselective. Nonselective LBBP captures the LBB and adjacent septal myocardium; selective LBBP captures the LBB alone. (sources/csp-ehra-2023, rating: high)
• LBB capture versus LVSP. LVSP captures working myocardium near the Purkinje exit sites — near-physiologic activation without proof of conduction-system capture. In a 415-patient comparison, LBBP was associated with better freedom from HFH or death than either LVSP or BIVP, while LVSP and BIVP did not differ. (sources/lbbp-lvsp-crt-jaccep-2024, rating: high)

How each state is proven is covered in concepts/LBBAP-Capture-Criteria.

Origins and foundational evidence (2019)

LBBP entered the literature as the answer to a specific failure: RV apical pacing causes dyssynchrony, biventricular pacing leaves non-responders, and His bundle pacing fails in exactly the patients who need resynchronisation — His-SYNC showed QRS cannot be normalised in almost half of patients with LBBB. (sources/lbbap-jacc-2019, rating: high)

• El-Sherif et al. first attempted LBB capture in acute studies, using HBP at ~20 V to excite the LBB.
• Huang et al. reported the first direct LBBP: standard HBP at 10 V failed to correct LBBB, whereas advancing the pacing tip toward the ventricle resolved LBBB at 0.5 V; LVEF rose 32% → 62%, and pacing produced RBBB at a short paced AV interval (40 ms) that normalised with AV-delay prolongation.
• Chen et al. developed the transventricular septal approach and supplied the founding QRS comparison: LBBP 111.85 ± 10.77 ms, RV septal pacing 154.80 ± 9.85 ms, RV apical pacing 165.50 ± 17.80 ms.

(All: sources/lbbap-jacc-2019, rating: high)

Key Concepts

• The target is a region, not a point. The lead lands in the midseptum; whether it captures the LBB, a fascicle or only myocardium depends on depth and local anatomy, not on a single fluoroscopic coordinate. (sources/lbb-anatomy-jacccase-2020, rating: medium)
• Capture is a spectrum, not a binary. Continuous pacing during screwing reveals six stations from RV septal pacing to selective LBBP, and the transition between them can occur within a few turns. (sources/continuous-pacing-lvsp-cjc-2023, rating: medium)
• Electrical and clinical success are different questions. A narrower QRS or a shorter LVAT proves resynchronisation; neither proves LBB capture, and neither has been shown to predict outcome better than the other. (sources/lbbp-vs-lvsp-criteria-jaccep-2021, rating: medium)
• The technique's risk is mechanical. Perforation, RBBB, complete heart block and tricuspid regurgitation are consequences of crossing the septum and of lead position, not of the pacing algorithm. (sources/csp-ehra-2023, rating: high)
• The evidence base is large but mostly observational. Cohort sizes exceed 1,000, but randomised evidence is limited to small trials and one modestly sized RCT; Left vs Left (n=2,136) is the definitive test. (sources/left-bundle-crt-ehj-2026, rating: high)

Evidence and Outcomes

Full detail: concepts/LBBAP-Outcomes.

(All rows: sources/lbbap-crt-jacc-2023, rating: high; sources/iclas-lbbap-crt-hrs-2025, rating: high; sources/iclas-hfmref-hrs-2025, rating: high; sources/lbbp-lvsp-crt-jaccep-2024, rating: high; sources/left-bundle-crt-ehj-2026, rating: high; sources/mri-lbbap-hrs-2025, rating: high)

• The consistent signal is HFH reduction, not mortality reduction. Three large cohorts agree on hospitalisation and none shows an adjusted mortality benefit; the closest is I-CLAS LVEF ≤50% (HR 0.82, P = .156).
• The randomised evidence is not yet supportive. LEFT-BUNDLE-CRT missed its ITT margin, with 20.7% crossover from BVP to LBBAP; the on-treatment analysis met the margin but was exploratory. A large powered trial — Left vs Left (n=2,136) — is still awaited. (sources/left-bundle-crt-ehj-2026, rating: high)
• LOT-CRT is the option when LBBAP alone leaves residual delay. It gives the greatest QRS narrowing, but its acute haemodynamic advantage over BVP is concentrated in QRS ≥171 ms with deep septal pacing. See concepts/LOT-CRT.
• Complications are procedure-specific: septal perforation 0–14.1% depending on detection, RBBB 19.9% (6.3% permanent), acute complete heart block 9.4% (2.6% permanent), TR worsening 7.3–32.6%, lead dislodgement 0.3–1.5%, loss of LBB capture 0.3–11.5%, coronary fistula 1.4–2.0%. (sources/csp-ehra-2023, rating: high)
• Lead performance is stable: in 618 implants, threshold was 0.65 V at implant and 0.69 V at 2 years; selective capture fell from 74.4% to 30.9%, attributed to falling myocardial threshold rather than loss of capture. (sources/longterm-lbbap-circep-2021, rating: high)

LBBAP vs RVP

(Table: sources/lbbp-vs-rvp-europace-2020, rating: medium; sources/csp-jaccep-2023, rating: very high)

• The direct comparison is electrical, not clinical. Beyond the narrower QRS in the table, LBBP had lower thresholds at implant (0.58 vs 0.71 V) that converged by 18 months (0.73 vs 0.76 V), higher sensing (13.9 vs 11.6 mV), and a larger transient troponin rise (0.13 vs 0.04 ng/mL), with more attempts (2.41 vs 1.49) and longer fluoroscopy (9.15 vs 3.92 min). (sources/lbbp-vs-rvp-europace-2020, rating: medium)
• Hard-outcome evidence is still pending. OptimPacing (NCT04624763, n=683) is testing LBBP vs RVP for death, HFH and pacing-induced cardiomyopathy; PROTECT-HF (n=2,600) tests CSP vs RVP; and LEAP (n=470) tests LVSP vs RVP. (sources/csp-jaccep-2023, rating: very high)
• The rationale is stronger than the outcome data: RV apical pacing causes electrical and mechanical dyssynchrony and increases heart failure and AF risk, and alternative RV sites are not superior. (sources/lbbap-jacc-2019, rating: high)

Implantation Technique

Full detail: concepts/LBBAP-Implantation-Technique.

1. Choose the entry site. Use the His potential or tricuspid valve summit in RAO 20–30°, then target 15–35 mm from the annulus. (sources/csp-ehra-2023, rating: high) The 9-partition fluoroscopic grid, contrast opacification of the annulus and intracardiac echocardiography each improve procedural surrogates. (sources/lbbap-9-partition-hrs-2020, rating: medium) (sources/contrast-guided-lbbap-hrs-2021, rating: medium) (sources/ice-guided-plbb-circep-2023, rating: high)
2. Cross perpendicularly. Orient the lead 10–40° (usually 20–30°) superior to horizontal in LAO 30–40°; advance with a smooth screwdriver effect, not a drill effect. (sources/csp-ehra-2023, rating: high)
3. Stop on right bundle branch delay in V1/V2. In LBBB, place a temporary backup pacing lead first, because mechanical RBBB can cause complete heart block. (sources/lbbap-implant-jce-2019, rating: medium)
4. Monitor depth continuously. Fixation beats, current of injury, impedance and V6RWPT each have defined stop rules; perforation beats and a sudden COI fall are the danger signals. (sources/csp-ehra-2023, rating: high)
5. Confirm capture using concepts/LBBAP-Capture-Criteria.
6. Program: threshold <1.5 V at 0.5 ms (ideally <1 V), bipolar sensing >4 mV, and the AV delay giving the narrowest paced QRS in LBBB. (sources/csp-ehra-2023, rating: high)

(Table: sources/lumenless-vs-stylet-leads-jcm-2024, rating: medium)

Perforation triad: marked COI fall, QS morphology and impedance <450 Ω. Overt perforation is repositioned, not simply withdrawn; late perforation requires anticoagulation; stable micro-perforation can be observed. (sources/lumenless-vs-stylet-leads-jcm-2024, rating: medium) (sources/csp-ehra-2023, rating: high)

Capture Criteria

Full detail: concepts/LBBAP-Capture-Criteria.

Specificity is quoted for the stated cut-off; where two cut-offs are listed, both values are given.

• The practical gold standard is an output-dependent transition, but it is demonstrable in only about one quarter of patients, and less often in the population that most needs adjudication. (sources/melos-lbbap-ehj-2022, rating: high)
• Direct evidence reorders the criteria: an abrupt Stim-LVAT shortening ≥10 ms is the most valuable (SP 100%), selective LBBP characteristics are 100% specific, a paced RBBB pattern is necessary but not sufficient, and paced QRS is longer during selective capture. (sources/lbbp-vs-lvsp-criteria-jaccep-2021, rating: medium)
• Sensitivity is a property of the cohort, not of the criterion. V6–V1 >33 ms is 71.8% sensitive in its validation cohort and 23% sensitive when re-tested in 115 patients with proven capture. (sources/ecg-lbbap-criteria-jaccep-2025, rating: medium)
• No criterion is validated in the majority who lack both a QRS transition and a within-patient comparator.

Rationale and Electrophysiology

Why pace distal to the block?

• RV apical pacing causes electrical and mechanical dyssynchrony and increases heart failure and AF risk; alternative RV sites are not superior. (sources/lbbap-jacc-2019, rating: high)
• Biventricular CRT leaves many non-responders and is itself nonphysiological.
• His bundle pacing is physiological but fails at the block: HBP success is lower in bundle branch block, the output needed to correct LBBB is high, and His-SYNC showed QRS cannot be normalised in almost half of patients with LBBB.
• The structural reasons HBP fails are the His bundle's ~1–2 mm diameter, difficult location, high and unstable thresholds in 5–10%, small sensed R-waves relative to atrial signals, and the risk of damaging the bundle during implantation.
• LBBP's premise is to pace distal to the block rather than proximal to it — capturing the left-sided conduction system below the site of conduction failure.

(All: sources/lbbap-jacc-2019, rating: high)

The LVSP–LBBP distinction

"The difference between LVSP and LBBP is capture of the LBB in LBBP and only myocardial capture in LVSP." LVSP captures working myocardium near where the Purkinje system normally exits — near-physiologic activation without proof of conduction-system capture; LBBP targets the specialised system itself. (sources/lvsp-vs-lbbp-cepc-2022, rating: high)

• The founding LVSP physiology (Little et al., 1982, canine): left-sided IVS pacing reproduced sinus-rhythm features — IVS activated left to right, pre-ejection LV pressure exceeding RV pressure, IVS motion identical to sinus rhythm — with better LV stroke volume and dP/dtmax than RV pacing in 7 dogs. (sources/lvsp-vs-lbbp-cepc-2022, rating: high)
• The anatomical rationale traces to Durrer's 1970 mapping of seven human hearts: three LV endocardial sites activated within 5 ms. (sources/lbbp-vs-lvsp-criteria-fcm-2022, rating: high)
• Mafi-Rad's 2016 cohort produced paced QRS 144 ± 20 vs 172 ± 33 ms (RV apical) vs 165 ± 17 ms (RV septal), with haemodynamics superior to RV pacing. (sources/lbbp-vs-lvsp-criteria-fcm-2022, rating: high)
• But LVSP's activation sequence is not physiological: coronary sinus mapping in 27 LBBP vs 16 LVSP patients found all LBBP patients preserved the intrinsic lateral→posterior LV sequence, while all LVSP patients reversed it. (sources/lbbp-vs-lvsp-criteria-fcm-2022, rating: high)
• LBBP in CRT shortened QRS from 168 ± 38 to 119 ± 12 ms, attributed to pacing beyond the site of block. (sources/lvsp-vs-lbbp-cepc-2022, rating: high)
• The verdict is unresolved: both modalities give near-physiologic activation and both show promise in CRT, but the review states twice that more long-term and head-to-head studies are needed. (sources/lvsp-vs-lbbp-cepc-2022, rating: high)

Ultra-high-frequency ECG separates the two techniques cleanly in 68 patients and 186 capture recordings. (sources/lvsp-vs-lbbp-dyssynchrony-hrs-2021, rating: high)

• nsLBBP preserves physiological LV lateral-wall depolarisation — its V5–V8 durations are statistically identical to nsHBP — but produces the worst interventricular dyssynchrony, because the RV is activated late by transseptal conduction.
• LVSP balances the ventricles but slows the LV: the delay between left septal myocyte capture and secondary His–Purkinje activation lets RV and LV wavefronts overlap, while the LV lateral wall depolarises cell-to-cell rather than through Purkinje fibres.
• A short V5 RWPT in LVSP does not prove fast conduction: 53% of LVSP (51/96) fell at ≤88 ms, inside the nsLBBP range; the shortest LVSP quartile had more dyssynchrony but identical V1–V8 depolarisation durations.
• V1 morphology is a depth marker: terminal rs/Rs versus r/R meant shallower insertion (10 vs 12 mm, P = .01) and less interventricular dyssynchrony (e-DYS +3 vs −16 ms, P < .001), with no difference in V2–V8 durations.
• A visible LBB potential in LVSP is a trap: all LVSP captures with a visible potential had V5 RWPT >10 ms longer than their native LBB-potential-to-V5 interval, indicating the LBB was not captured.
• The clinical corollary: if the goal is the most physiological LV activation, nsHBP and nsLBBP should be preferred over LVSP, because LVSP slows LV lateral-wall depolarisation irrespective of V5 RWPT or V1 morphology.

(All: sources/lvsp-vs-lbbp-dyssynchrony-hrs-2021, rating: high)

Why selective capture widens the QRS

Paced QRS duration is longer during selective LBBP than during nonselective LBBP or LVSP. LBBP gives rapid LV activation but delayed RV activation; in nonselective LBBP, septal myocardial capture partially fuses with and neutralises that delay, whereas in selective LBBP the RV is maximally delayed. Paced QRS therefore reflects the fusion of LV and RV activation and "was not helpful to distinguish LVSP from LBB capture". (sources/lbbp-vs-lvsp-criteria-jaccep-2021, rating: medium)

• A second cohort reproduces the inversion in an intrapatient design: Stim-QRSend was narrowest in IVSP2 (136.6 ± 15.2 ms) — an intermediate state before capture — and widest in selective LBBP (150.6 ± 19.3 ms; P < 0.05 vs nonselective 140.0 ± 17.1), while Stim-V6RWPT simultaneously shortened as expected. (sources/continuous-pacing-lvsp-cjc-2023, rating: medium)
• The implication: QRS narrowing proves resynchronisation, not conduction-system capture.
• The two-wavefront model: the paced QRS reflects collision between conduction-system activation and local myocardial cell-to-cell activation. During LBB capture the fast initial phase dominates and the collision produces a slow, notched downstroke; during LVSP the slow myocardial phase dominates. (sources/ecg-lbbap-criteria-jaccep-2025, rating: medium)

Proximal vs distal: the LVAT–QRS trade-off

• Distal LBB stimulation: shorter LVAT but wider QRS (delayed retrograde RBB activation → more interventricular dyssynchrony). (sources/csp-jaccep-2023, rating: very high)
• Proximal stimulation: narrower QRS but longer LVAT.
• Best interventricular synchrony occurs when the first late r appears in V1 (LVSP1); deeper positions improve LV activation at the cost of widening QRS.
• Whether shorter LVAT or narrower QRS is clinically superior is unresolved.

(All: sources/csp-jaccep-2023, rating: very high)

Anodal and bipolar capture

• Anodal (ring) capture produces a shorter QRS via earlier RV activation. (sources/csp-jaccep-2023, rating: very high)
• The mechanism is RV septal myocardial capture, not right bundle capture (confirmed by ECGi).
• Despite the shorter QRS, anodal capture provides no additional haemodynamic benefit, and routine anodal programming is not recommended. (sources/csp-jaccep-2023, rating: very high)
• Bipolar pacing passes through two output-dependent transitions, not one, because the anode lies on the right side of the septum and can capture RV myocardium: (sources/bipolar-lbbp-hrs-2022, rating: medium)
  • High output — nonselective bipolar LBB: narrowest QRS 118.2 ± 14.2 ms, shortest V1 RWPT 95.6 ± 10.3 ms, constant V6 RWPT 64.8 ± 7.7 ms.
  • First transition (loss of anodal capture): QRS 133.8 ± 15.8 ms, V1 RWPT 107.5 ± 12.7 ms, V6 RWPT unchanged; threshold falls from 2.5 ± 1.2 V to 0.8 ± 0.4 V.
  • Second transition: either selective cathodal LBB capture (V1 RWPT 120.5 ms, QRS 145.3 ms, threshold 0.5 V) or LVS-only capture (V6 RWPT 82.8 ms).
• The speculation: high-output nonselective bipolar LBB pacing might be an "ideal" synchronisation mode — but it requires ~2.5 V, has no haemodynamic or outcome data, and its mechanism is inferred from EGM morphology rather than activation mapping.

Who does not benefit

• ~36% of patients with LBBB have intact Purkinje activation, so the block is not in the left bundle and pacing it cannot correct the underlying problem; no surface ECG feature reliably identifies them before implantation. (sources/lbbap-jacc-2019, rating: high)
• Whether conduction-system capture is necessary for clinical benefit is open: LVSP alone may provide adequate resynchronisation via retrograde conduction-system engagement, and the LEAP trial (NCT04595487, n=470) tests LVSP versus RVP directly. (sources/csp-ehra-2023, rating: high)

Contradictions / Open Questions

• A third of the target population may not benefit, and cannot be identified in advance. ~36% of patients with LBBB have intact Purkinje activation — the block is not in the left bundle, so pacing the LBB does not correct the underlying problem. No surface ECG feature reliably separates true discrete LBBB from intact-Purkinje LBBB before implantation. (sources/lbbap-jacc-2019, rating: high)
• Is conduction-system capture necessary for clinical benefit? LVSP alone may provide adequate resynchronisation through retrograde conduction-system engagement. The LEAP trial tests LVSP versus RVP, but no trial tests whether achieving LBB capture changes outcomes compared with LVSP. (sources/csp-ehra-2023, rating: high) (sources/csp-jaccep-2023, rating: very high)
• Is pursuing selective capture worth it — and is it even stable? Selective capture is 100% specific, but it is inflated by repeated testing, falls from ~75% at implant to 30.9% at follow-up, and routine post-implant outputs capture local myocardium in most patients anyway. The Fuwai guide warns that overemphasis on the potential and selective capture increases perforation risk through overscrewing. (sources/longterm-lbbap-circep-2021, rating: high) (sources/lbbap-implant-jce-2019, rating: medium)
• The definition of "success" is not standardised. Registries accept LBBP or LVSP as success, so MELOS reports 92.4% while finding 21.5% septal-only, and the SDL registry reports 94.6% while finding 27% septal-only. Neither publishes a success rate restricted to confirmed LBB capture. Until a trial says which modality is better, a high LBBAP success rate is a high rate of achieving something. (sources/melos-lbbap-ehj-2022, rating: high) (sources/stylet-lbbap-jce-2022, rating: medium)
• Heart failure hospitalisation falls, but mortality does not. Three cohorts agree on HFH and none shows an adjusted mortality benefit. A therapy that reduces hospitalisation without reducing death is useful but not disease-modifying, and the null may reflect confounding by indication rather than a true absence of effect. (sources/iclas-lbbap-crt-hrs-2025, rating: high) (sources/lbbap-crt-jacc-2023, rating: high)
• The electrical metrics disagree about which configuration is better. Anodal capture shortens the surface QRS while lengthening LVAT and increasing dispersion; selective LBBP is the most convincing capture state but produces the longest paced QRS. QRS duration, activation-time dispersion and proof of capture rank the same configurations differently, and no study has tested which ranking predicts outcome. (sources/crp-lbbap-jice-2023, rating: low) (sources/lbbp-vs-lvsp-criteria-jaccep-2021, rating: medium)
• Is LBBAP generalisable outside expert centres? MELOS found the learning curve plateaus only after 250 cases. The SDL registry found success independent of centre volume, but every operator was a certified electrophysiologist with >5 years of device experience and 27% of implants were LVSP — so volume-independence describes experts, not novices. (sources/melos-lbbap-ehj-2022, rating: high) (sources/stylet-lbbap-jce-2022, rating: medium)
• Long-term lead extraction is unestablished. There are no data for LBBAP leads in the LBB position, and the lumenless lead accepts no locking stylet; special tools are likely required. (sources/csp-ehra-2023, rating: high)

Connections

• Related to concepts/Conduction-System-Pacing — the wider family (HBP, LBBP, LFP, LVSP)
• Related to concepts/His-Bundle-Pacing — the proximal alternative and its failure modes
• Related to concepts/Cardiac-Resynchronization-Therapy — the comparator strategy
• Related to concepts/LOT-CRT — the hybrid option in wide QRS and IVCD
• Related to concepts/Pacing-Induced-Cardiomyopathy — an important indication
• Related to concepts/Cardiac-Refractoriness — the ERP differential behind programmed-stimulation capture testing
• Related to concepts/LBBB-Criteria — identifying the substrate before implantation
• Related to concepts/Electrical-Resynchronization-Metrics — why QRS and activation metrics diverge
• Related to entities/Heart-Failure — the clinical syndrome being treated
• Related to entities/Atrial-Fibrillation — LBBAP is preferred when AV junction ablation is planned
• Related to entities/ICD — LBBA defibrillation leads and antitachycardia pacing

Sources

Sources for this hub and its three detailed pages:

Guidelines, reviews and foundations

• sources/csp-ehra-2023
• sources/csp-jaccep-2023
• sources/lbbap-jacc-2019
• sources/lbbap-beginners-guide-hrs-2019
• sources/lvsp-vs-lbbp-cepc-2022
• sources/lbbp-vs-lvsp-criteria-fcm-2022

Capture criteria and physiology

• sources/melos-lbbap-ehj-2022
• sources/lbbp-vs-lvsp-criteria-jaccep-2021
• sources/v6-v1-interpeak-europace-2022
• sources/lbb-capture-criteria-hrs-2021
• sources/ecg-score-lbb-capture-europace-2023
• sources/ecg-lbbap-criteria-jaccep-2025
• sources/programmed-septal-stim-lbbp-jce-2020
• sources/denker-pes-lbbap-jce-2020
• sources/denker-hps-refractoriness-circ-1983
• sources/continuous-pacing-lvsp-cjc-2023
• sources/lvsp-vs-lbbp-dyssynchrony-hrs-2021
• sources/bipolar-lbbp-hrs-2022

Implantation and safety

• sources/lbb-anatomy-jacccase-2020
• sources/lbbap-9-partition-hrs-2020
• sources/contrast-guided-lbbap-hrs-2021
• sources/ice-guided-plbb-circep-2023
• sources/lbbap-implant-jce-2019
• sources/lbbap-avb-hrs-2019
• sources/lumenless-vs-stylet-leads-jcm-2024
• sources/stylet-lbbap-jce-2022
• sources/fixation-beats-hrs-2020
• sources/m-beat-jce-2022
• sources/coi-lead-depth-hrs-2022
• sources/lbb-current-of-injury-jce-2020
• sources/coi-lbbap-hrs-2024
• sources/impedance-lbbap-jce-2022
• sources/septal-perforation-hrs-2022
• sources/tricuspid-regurgitation-lbbap-hrs-2023

Outcomes, trials and follow-up

• sources/longterm-lbbap-circep-2021
• sources/lbbp-vs-rvp-europace-2020
• sources/crp-lbbap-jice-2023
• sources/lbbap-crt-jacc-2023
• sources/iclas-lbbap-crt-hrs-2025
• sources/iclas-hfmref-hrs-2025
• sources/lbbp-lvsp-crt-jaccep-2024
• sources/left-bundle-crt-ehj-2026
• sources/mri-lbbap-hrs-2025
• sources/leadr-lbbap-hrs-2025
• sources/lot-crt-hrs-2021
• sources/lot-crt-circep-2023
• sources/lot-crt-circep-2024
• sources/lot-crt-hrs-2025
• sources/lot-europace-2026
• sources/lot-crt-vt-ane-2026
• sources/lbbap-atp-jaccep-2026
• sources/scar-csp-jce-2023