Stylet-Driven Lead Vs. Lumenless Lead for Left Bundle Branch Area Pacing: Systematic Literature Review and Meta-Analysis
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BackgroundLeft bundle branch area pacing (LBBAP) offers cardiac synchrony benefits over conventional ventricular pacing. Although many studies on LBBAP have used lumenless pacing leads (LLLs), stylet-driven pacing leads (SDLs) can also be used. In this study, we compared LLLs and SDLs for LBBAP through a systematic review and meta-analysis of the literature.MethodsThe PubMed, Embase, and Cochrane Library databases were searched for full-text articles on LBBAP from their respective inception dates to April 9, 2024. The studies comparing LLLs and SDLs were extracted, and electrophysiological characteristics and procedural outcomes were analyzed. Of 2201 articles on LBBAP, 7 met the inclusion criteria of comparing LLLs and SDLs as implanted pacing leads.ResultsThe overall pooled analysis showed noninferiority in implant success rates for SDLs compared with LLLs for LBBAP (89% vs. 94%, odds ratio: 0.80, 95% confidence interval [CI]: 0.37-1.72, p = 0.566). The paced QRS duration of LBBAP using SDLs was not significantly different from that using LLLs (standardized mean difference: -0.19 ms, 95% CI: -0.50 to 0.12, p = 0.239). There were no differences in the stimulus to the left ventricular activation time and paced QRS duration between the two groups. Follow-up pacing parameters were stable in both groups.ConclusionLBBAP using SDLs is noninferior to that using LLLs in terms of implantation success. There were no differences in procedural and electrophysiological characteristics between the two groups.

키워드

conduction system pacingleft bundle branch area pacinglumenless pacing leadmeta-analysisstylet-driven pacing leadsCARDIAC RESYNCHRONIZATION THERAPYHEART-FAILURE
제목
Stylet-Driven Lead Vs. Lumenless Lead for Left Bundle Branch Area Pacing: Systematic Literature Review and Meta-Analysis
저자
Yu, Ga-InKim, Tae-HoonCho, Yun-HoBae, Jae-SeokAhn, Jong-HwaJang, Jeong YoonKwak, Choong Hwan
DOI
10.1111/pace.15209
발행일
2025-07
유형
Article
저널명
PACE - Pacing and Clinical Electrophysiology
48
7
페이지
682 ~ 690