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Stylet-Driven Lead Vs. Lumenless Lead for Left Bundle Branch Area Pacing: Systematic Literature Review and Meta-Analysis

Authors
 Yu, Ga-In  ;  Kim, Tae-Hoon  ;  Cho, Yun-Ho  ;  Bae, Jae-Seok  ;  Ahn, Jong-Hwa  ;  Jang, Jeong Yoon  ;  Kwak, Choong Hwan 
Citation
 PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, Vol.48(7) : 682-690, 2025-07 
Journal Title
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY
ISSN
 0147-8389 
Issue Date
2025-07
Keywords
conduction system pacing ; left bundle branch area pacing ; lumenless pacing lead ; meta-analysis ; stylet-driven pacing leads
Abstract
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.
Full Text
https://onlinelibrary.wiley.com/doi/10.1111/pace.15209
DOI
10.1111/pace.15209
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/208258
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