Left bundle branch pacing versus standard pacing for heart block
Compares two pacemaker lead positions in adults with heart block.
Plain-language title generated from the registry record
Registry title: Conduction System Pacing With Left Bundle Branch Pacing as Compared to Standard Right Ventricular Pacing
Key facts
- Where
- Montreal, CanadaSee the site
Where in Canada
- McGill University Health Centre Research InstituteMontreal, CanadaTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- McGill University Health Centre/Research Institute of the McGill University Health Centre
- Trial code
- NCT05015660
- Record updated
- 11 March 2026
- Original description
High burden right ventricular (RV) pacing has been shown to increase cardiovascular mortality, incidence of heart failure (HF), worsen left ventricular (LV) function and accelerate the development of atrial fibrillation (AF). High percentage ventricular pacing and wider paced QRS in the setting of normal baseline LV ejection fractions have consistently been shown to be independent risk factors for pacing-induced cardiomyopathy. Left bundle branch pacing (LBBP) has emerged as a potential alternative pacing mechanism that may avoid LV dyssynchrony and pacing-induced LV dysfunction by mimicking native electrical conduction.Read full original descriptionShow less
LEFT Bundle Pacing vs Standard Right Ventricular Pacing for Heart Failure
High burden right ventricular (RV) pacing has been shown to increase cardiovascular mortality, incidence of heart failure (HF), worsen left ventricular (LV) function and accelerate the development of atrial fibrillation (AF). High percentage ventricular pacing and wider paced QRS in the setting of normal baseline LV ejection fractions have consistently been shown to be independent risk factors for pacing-induced cardiomyopathy. Left bundle branch pacing (LBBP) has emerged as a potential alternative pacing mechanism that may avoid LV dyssynchrony and pacing-induced LV dysfunction by mimicking native electrical conduction.
Inclusion: Age ≥ 18 years; Patients with an ejection fraction of >35%; Patients with an indication for ventricular pacing and high-degree atrioventricular block where the degree of anticipated RV pacing is >90% including:; Third degree AV block; Symptomatic or asymptomatic second-degree AV block; First degree AV block ≥ 280ms with a narrow QRS, or ≥ 240ms with an intraventricular delay (QRS duration ≥120ms); Echocardiogram within the last 3 months, with ability to have DICOM images.
Exclusion: Any prior attempt at implantation of an ICD, CRT, HBP, or LBBP; Other serious medical condition with life expectancy of <2 years; Indication for an implantable cardioverter defibrillator; Presence of a mechanical tricuspid valve; Lack of capacity to consent; Pregnancy; Patients in whom the conduction system abnormality is expected to be transient or recover over time; Patients with permanent atrial fibrillation.