Introduction
Since its first description1 , selective and
non-selective His-bundle pacing (HBP) has proven to be a feasible and
safe procedure, with morbidity and mortality outcomes comparable or
superior to those of conventional endocardial right-ventricular
pacing.2,3 It has also achieved excellent outcomes in
candidates for cardiac resynchronization therapy
(CRT).4,5 Nevertheless, well-documented limitations of
HBP include a long learning curve, higher energy requirement, greater
radiological exposure, and the possible need for reintervention due to
lead-related complications.6 In addition, the success
rate of this procedure is lower in patients with interventricular
conduction defects, because branches of the His-Punkinje system cannot
be recruited when the block zone is more distal from the pacing
point.7
Left bundle branch area pacing (LBBAP), in which the lead penetrates
into the interventricular septum, is a feasible and safe alternative
option in candidates for antibradycardia therapy (ABT) or CRT and has
also obtained similar or better outcomes in comparison to conventional
pacing.8,9 However, no studies have been published
that compare results between these two techniques. The objective of the
present study was to compare outcomes between HBP and LBBAP at
implantation and at 3 months.