Right ventricular function preservation in conduction system pacing (CSP): Impact of lead-to tricuspid annulus distance left bundle branch area pacing (LBBAP) vs. his-bundle pacing (HBP)

Mirza, Try Ahmad; Pranata, Raymond; Kamarullah, William; Iqbal, Mohammad; Hidayat, Syarief; Achmad, Chaerul; Karwiky, Giky

doi:10.21776/ub.hsj.2026.007.01.15

Akses terbuka Jurnal SINTA 1

Right ventricular function preservation in conduction system pacing (CSP): Impact of lead-to tricuspid annulus distance left bundle branch area pacing (LBBAP) vs. his-bundle pacing (HBP)

Heart Science Journal · Vol. 7 No. 1 (2026) · hlm. 85–91

DOI: 10.21776/ub.hsj.2026.007.01.15
ISSN: 2721-9984, 2721-9976
Terbit: 2026-01-31
Penerbit: Universitas Brawijaya
Bahasa: en
Lisensi: creativecommons.org/licenses/by/4.0

Abstrak

Background: Pacemaker remains the most effective therapy for the management of conduction disorders; however, traditional methods of right ventricular (RV) pacing have given way to more advanced conduction system pacing (CSP) techniques, such as His Bundle Pacing (HBP) and Left Bundle Branch Area Pacing (LBBAP). Objective: The impact of these two techniques on RV function is the objective of this study. Methods: This longitudinal prospective cohort study investigates differences in RV function among patients who have undergone HBP and those who have received LBBAP, using the echocardiographic parameters: fractional area change (FAC), RV global longitudinal strain (RVGLS), tricuspid annular plane systolic excursion (TAPSE), and the progression of tricuspid regurgitation (TR), with a focus on lead placement distance to the tricuspid annulus (TA) within LBBAP subgroup. Result: Among the 64 patients (33 in the HBP group and 31 in the LBBAP group), LBBAP patients with a lead-to-TA distance > 21.5 mm showed significantly better preservation of RV function across all metrics compared to HBP, specifically noted in TAPSE (1.83±5.34 vs. -1.06±3.77 in HBP, p=0.048), FAC (7.83±9.98 vs. 2.42±10.63 in HBP, p=0.011), and also RVGLS improvement (p=0.020). Conclusion: LBBAP with lead placement > 21.5 mm from the TA better preserves RV function compared to HBP mainly by minimizing mechanical interference with the tricuspid valve and reducing TR risk.

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Padjadjaran University

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Rekan penulis	Organisasi	Artikel bersama
Gildasya Gildasya	Padjadjaran University	1
Eriska Riyanti	Padjadjaran University	1

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Sumber metadata: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.

Metadata asli (oai_dc)

<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">Right ventricular function preservation in conduction system pacing (CSP): Impact of lead-to tricuspid annulus distance left bundle branch area pacing (LBBAP) vs. his-bundle pacing (HBP)</dc:title>
	<dc:creator xml:lang="en">Mirza, Try Ahmad</dc:creator>
	<dc:creator xml:lang="en">Pranata, Raymond </dc:creator>
	<dc:creator xml:lang="en">Kamarullah, William </dc:creator>
	<dc:creator xml:lang="en">Iqbal, Mohammad </dc:creator>
	<dc:creator xml:lang="en">Hidayat, Syarief </dc:creator>
	<dc:creator xml:lang="en">Achmad, Chaerul </dc:creator>
	<dc:creator xml:lang="en">Karwiky, Giky </dc:creator>
	<dc:subject xml:lang="en">Right Ventricular Function</dc:subject>
	<dc:subject xml:lang="en">His-Bundle Pacing</dc:subject>
	<dc:subject xml:lang="en">Lead-to-Tricuspid Annulus Distance Left Bundle Branch Area Pacing</dc:subject>
	<dc:description xml:lang="en">Background: Pacemaker remains the most effective therapy for the management of conduction disorders; however, traditional methods of right ventricular (RV) pacing have given way to more advanced conduction system pacing (CSP) techniques, such as His Bundle Pacing (HBP) and Left Bundle Branch Area Pacing (LBBAP).
Objective: The impact of these two techniques on RV function is the objective of this study.
Methods: This longitudinal prospective cohort study investigates differences in RV function among patients who have undergone HBP and those who have received LBBAP, using the echocardiographic parameters: fractional area change (FAC), RV global longitudinal strain (RVGLS), tricuspid annular plane systolic excursion (TAPSE), and the progression of tricuspid regurgitation (TR), with a focus on lead placement distance to the tricuspid annulus (TA) within LBBAP subgroup.
Result: Among the 64 patients (33 in the HBP group and 31 in the LBBAP group), LBBAP patients with a lead-to-TA distance &amp;gt; 21.5 mm showed significantly better preservation of RV function across all metrics compared to HBP, specifically noted in TAPSE (1.83±5.34 vs. -1.06±3.77 in HBP, p=0.048), FAC (7.83±9.98 vs. 2.42±10.63 in HBP, p=0.011), and also RVGLS improvement (p=0.020).
Conclusion: LBBAP with lead placement &amp;gt; 21.5 mm from the TA better preserves RV function compared to HBP mainly by minimizing mechanical interference with the tricuspid valve and reducing TR risk.</dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2026-01-31</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/20541</dc:identifier>
	<dc:identifier>10.21776/ub.hsj.2026.007.01.15</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 7 No. 1 (2026): Accelerating Clinical Breakthroughs: The Journey from Molecular Discovery to Patient Care; 85-91</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2026.007.01</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/20541/563</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2026 Try Ahmad Mirza, Raymond  Pranata, William  Kamarullah, Mohammad  Iqbal, Syarief  Hidayat, Chaerul  Achmad, Giky  Karwiky</dc:rights>
	<dc:rights xml:lang="en">http://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>