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Mohammad Iqbal
Universitas Muria Kudus
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Journal : Heart Science Journal

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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
Heart Science Journal Vol. 7 No. 1 (2026): Accelerating Clinical Breakthroughs: The Journey from Molecular Discovery to Pa
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.01.15

Abstract

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.
Co-Authors Abdul Nasir, Abdul Achmad Latif Ahwan, Dedy Noor Alfidro, Muhammad Reza Alvida Mustika Rukmi Ari Darmawan Ari Irawan Bachtiar Arif, Ahmad Budi Gunawan Chaerul Achmad Deasyana, Lusy Devita, Rahma Dewa, Krisna Kumara Dimas Anton Asfani Dwi Vernanda Dyah, Meiska Endang Supriyati Endang Supriyati Erick Febriyanto Fadlila, Muhammad Irfan Fahrudi, Agung Nugroho Luthfi Imam Fandi Ahmad Fauzan, Yuda Firdaus, Rivaldi Firmansyah, Fatkhiyatur Riza Haryati Haryati Hasanuddin, Iskandar Hendy Hermianto, Kukuh Husain, Ilyas H Idris, Nuramaliah Imam Abdul Rozaq Imam Mukhlash Indarto HS, Abdu Fitrah Irsyada, Rahmat Jazuli, Abdul Wahid Kadafi, Alsa Ahmad Kamarullah, William Kapi, Florentinus B Karwiky, Giky Kasim, Sri Imelda kharisma Putra, Irfan Kholid Mawardi, Mukhammad Krishananto , Andreas Budi Larasati, Ika Larasati, Ika Latif, Achmad Listiani Listiani Longkop, Sutriani Afrilia Masesa Angga Wijaya Melyani Melyani, Melyani Mirza, Try Ahmad Mohammad Dahlan, Mohammad Mohammad Isa Irawan NINING WAHYUNINGSIH Nita Andriyani Budiman Noor Yulita Dwi Setyaningsih Nur Aini Fauziyah Nur Sholikin Nuralan, Sitti Nurfitria Khoirunnisa Nurul Hidayat Pangestuti, Edriana Pranata, Raymond Putra, Febriandika Qamarani, Syabibah Yusrina Rachma Agusti, Rosalita Rakim, Aditya Achmad Ramdhani, Muhammad Ilham Rasyadan Taufiq Probojati Rina Hastuti Rohman, Fadlur Rohman, Fadlur Rosalita Rachma Agusti Rudi Salam Rukmini, Meme Saeful Anam, Saeful Sanawiri, Brillyanes Solekhan Solekhan Solekhan Solekhan Sri Mulyani Sulistianti, Putri Sumantra Yasa, I Kadek Java Suprihatin Suprihatin Supriyono, Joko Susilawati, Susilawati Syarief Hidayat Tri Listyorini Tutik Khotimah Ulfah, Mariyah Usman Usman Utomo, Bagus Verlandes, Yuliasnita Widagdo, Ridwan Yusri Abdillah Zalfaa, Alyaa zalyus, firda melani