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

Ga‐In Yu; Tae‐Hoon Kim; Yun‐Ho Cho; Jae‐Seok Bae; Jung-Min Ahn; Jeong Yoon Jang; Choong Hwan Kwak

doi:10.1111/pace.15209

journal article Open Access May 23, 2025

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

Ga‐In Yu

Tae‐Hoon Kim

Yun‐Ho Cho Jae‐Seok Bae Jung-Min Ahn

Jeong Yoon Jang Choong Hwan Kwak

Pacing and Clinical Electrophysiology Vol. 48 No. 7 pp. 682-690 · Wiley

View at Publisher Save 10.1111/pace.15209

Abstract

ABSTRACT

Background
Left 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.

Methods
The 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.

Results

The 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.

Conclusion
LBBAP 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.

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Details

Published: May 23, 2025
Vol/Issue: 48(7)
Pages: 682-690
License: View

Authors

G

Ga‐In Yu