Global Myocardial Work Efficiency and Left Ventricular Ejection Fraction After Left Bundle Branch Area Pacing Versus Right Ventricular Pacing: Extended Follow-Up of a Prospective Cohort

Background/Objectives: Evidence on myocardial-work indices beyond 12 months after left bundle branch area pacing (LBBAP) remains limited. We compared global myocardial work efficiency (GWE) and the left ventricular ejection fraction (LVEF) after LBBAP and right ventricular mid-septal pacing (RVP).

Methods

This prospective, non-randomised cohort included 63 patients with advanced atrioventricular block and preserved pre-implantation LVEF: 34 assigned to an LBBAP strategy and 29 to RVP. Ventricular pacing burden was 100%. GWE was the primary endpoint; LVEF was the principal adjusted secondary endpoint. Analyses adjusted for age, sex, hypertension and atrial fibrillation. Follow-up averaged approximately two years, with an individual range of 0.64–4.23 years.