The Application Study of Left Bundle Branch Pacing in Single-Chamber Cardioverter Defibrillator Implantation

Abstract

The implantation of implantable cardioverter-defibrillators (ICDs) currently utilizes traditional right ventricular apex pacing and low ventricular septal pacing. However, these pacing modes can lead to electrical and mechanical dyssynchrony, particularly in patients who are pacing-dependent, significantly increasing the risk of heart failure exacerbation. Currently, His-Purkinje System Pacing (HPCSP), which includes left bundle branch pacing (LBBP) and His bundle pacing (HBP), can achieve synchronized electrical conduction and mechanical movement of the heart. This approach significantly shortens the duration of the QRS complex under pacing and markedly improves the clinical prognosis of patients. LBBP is simpler and has a more stable threshold than HBP. Clinical studies have demonstrated the feasibility and safety of LBBP, showing it to have a relatively low pacing threshold, infrequent complications, and a high procedural success rate. However, there are very few clinical studies on the application of LBBP in ICD implantation. The purpose of this study is to analyze the feasibility, effectiveness, and advantages of LBBP in ICD implantation, with the aim of providing a reference for its clinical application.