Leadless biventricular left bundle and endocardial lateral wall pacing versus left bundle only pacing in left bundle branch block patients
Open accessAbstract
Biventricular endocardial (BIV-endo) pacing and left bundle pacing (LBP) are novel delivery methods for cardiac resynchronization therapy (CRT). Both pacing methods can be delivered through leadless pacing, to avoid risks associated with endocardial or transvenous leads. We used computational modelling to quantify synchrony induced by BIV-endo pacing and LBP through a leadless pacing system, and to investigate how the right-left ventricle (RV-LV) delay, RV lead location and type of left bundle capture affect response. We simulated ventricular activation on twenty-four four-chamber heart meshes inclusive of His-Purkinje networks with left bundle branch block (LBBB). Leadless biventricular (BIV) pacing was simulated by adding an RV apical stimulus and an LV lateral wall stimulus (BIV-endo lateral) or targeting the left bundle (BIV-LBP), with an RV-LV delay set to 5 ms. To test effect of prolonged RV-LV delays and RV pacing location, the RV-LV delay was increased to 35 ms and/or the RV stimulus was moved to the RV septum. BIV-endo lateral pacing was less sensitive to increased RV-LV delays, while RV septal pacing worsened response compared to RV apical pacing, especially for long RV-LV delays. To investigate how left bundle capture affects response, we computed 90% BIV activation times (BIVAT-90) during BIV-LBP with selective and non-selective capture, and left bundle branch area pacing (LBBAP), simulated by pacing 1 cm below the left bundle. Non-selective LBP was comparable to selective LBP. LBBAP was worse than selective LBP (BIVAT-90: 54.2 ± 5.7 ms vs. 62.7 ± 6.5, p < 0.01), but it still significantly reduced activation times from baseline. Finally, we compared leadless LBP with RV pacing against optimal LBP delivery through a standard lead system by simulating BIV-LBP and selective LBP alone with and without optimized atrioventricular delay (AVD). Although LBP alone with optimized AVD was better than BIV-LBP, when AVD optimization was not possible BIV-LBP outperformed LBP alone, because the RV pacing stimulus shortened RV activation (BIVAT-90: 54.2 ± 5.7 ms vs. 66.9 ± 5.1 ms, p < 0.01). BIV-endo lateral pacing or LBP delivered through a leadless system could potentially become an alternative to standard CRT. RV-LV delay, RV lead location and type of left bundle capture affect leadless pacing efficacy and should be considered in future trial designs.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In these studies, both subject-specific and synthetic cohorts were created.
“In these studies, both subject-specific and synthetic cohorts were created.”
From Credibility assessment of in silico clinical trials for medical devices (2024) · cites this paper as [43]
Methods (Electrophysiology simulations; page unavailable) describes 24 heart geometries derived from patients, but says they were published in an earlier study rather than created here. The same section describes generating a His-Purkinje network for each geometry, and Discussion (Limitations; page unavailable) calls those networks synthetic. The paper therefore supports patient-derived models with synthetic components, not the creation of separate subject-specific and synthetic cohorts. (LLM, conf=0.86)
Experimental — accuracy not yet measuredSynthetic patients were created from the subject-specific virtual patients by introducing different presentations of electrophysiology pathologies in each patient.
“Synthetic patients were then created from the subject-specific virtual patients, by introducing different presentations of electrophysiology pathologies in each patient (case B in Fig 1).”
From Credibility assessment of in silico clinical trials for medical devices (2024) · cites this paper as [43]
These models were used in [41-43] to study the efficacy of different cardiac resynchronization therapy pacing protocols for heart failure patients with left bundle branch block.
“These models were used in [41–43] to study the efficacy of different cardiac resynchronization therapy (CRT) pacing protocols for heart failure patients with left bundle branch block (LBBB).”
From Credibility assessment of in silico clinical trials for medical devices (2024) · cites this paper as [43]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Bristow, M. R., Saxon, L. A., Boehmer, J., Krueger, S., Kass, D. A., De Marco, T., Carson, P., DiCarlo, L., DeMets, D., White, B. G., et al. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa032423 · Cited by 5,812 · see citing works
Sequential Versus Simultaneous Biventricular Resynchronization for Severe Heart Failure
Søgaard, P., Egeblad, H., Pedersen, A. K., Kim, W. Y., Kristensen, B. Ø., HANSEN, P. S., & Mortensen, P. T. (2002) · Circulation · doi:10.1161/01.cir.0000034512.90874.8e · Cited by 497 · see citing works
Derval, N., Paul Steendijk, A., Gula, L. J., Deplagne, A., Laborderie, J., Sacher, F., Knecht, S., Wright, M. J., Nault, I., Ploux, S., et al. (2009) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2009.08.045 · Cited by 267 · see citing works
Reduced Ventricular Volumes and Improved Systolic Function With Cardiac Resynchronization Therapy
Rao, R. K., Kumar, U., Schafer, J. E., Viloria, E., Lurgio, D. D., & Foster, E. (2007) · Circulation · doi:10.1161/circulationaha.106.634444 · Cited by 229 · see citing works
Cardiac Resynchronization Therapy With Wireless Left Ventricular Endocardial Pacing
Reddy, V. Y., Miller, M. A., Neuzil, P., Søgaard, P., Butter, C., Seifert, M., Delnoy, P. P., van Erven, L., Schalji, M., Boersma, L. V. A., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.02.059 · Cited by 214 · see citing works
Inhomogeneous Transmural Conduction During Early Ischaemia in Patients with Coronary Artery Disease
Taggart, P. I., Sutton, P. M., Tobias Opthof, A., Coronel, R., Trimlett, R., Pugsley, W. B., & Kallis, P. (2000) · Journal of Molecular and Cellular Cardiology · doi:10.1006/jmcc.2000.1105 · Cited by 200 · see citing works
Neic, A., Campos, F. O., Prassl, A. J., Niederer, S., Bishop, M. J., Vigmond, E. J., & Plank, G. (2017) · Journal of Computational Physics · doi:10.1016/j.jcp.2017.06.020 · Cited by 192 · see citing works
Auricchio, A., Delnoy, P.-P., Butter, C., Brachmann, J., van Erven, L., Spitzer, S., Moccetti, T., Seifert, M., Markou, T., Laszo, K., et al. (2014) · EP Europace · doi:10.1093/europace/eut435 · Cited by 191 · see citing works
Boriani, G., Muller, C. P., Seidl, K. H., Grove, R., Vogt, J., Dänschel, W., Schuchert, A., DJIANE, P., Biffi, M., Becker, T., et al. (2006) · American Heart Journal · doi:10.1016/j.ahj.2005.08.019 · Cited by 177 · see citing works
Morgan, J. M., Biffi, M., Gellér, L., Leclercq, C., Ruffa, F., Tung, S., Defaye, P., Yang, Z., Gerritse, B., van Ginneken, M. M. E., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehv723 · Cited by 165 · see citing works
Dickstein, K., Normand, C., Auricchio, A., Bogale, N., Cleland, J. G. F., Gitt, A. K., Stellbrink, C., Anker, S. D., Filippatos, G. S., Gasparini, M., et al. (2018) · European Journal of Heart Failure · doi:10.1002/ejhf.1142 · Cited by 132 · see citing works
Bayer, J. D., Prassl, A. J., Pashaei, A., Gómez, J. F., Frontera, A., Neic, A., Plank, G., & Vigmond, E. J. (2018) · Medical Image Analysis · doi:10.1016/j.media.2018.01.005 · Cited by 131 · see citing works
van Deursen, C. J. M., van Geldorp, I. E., Rademakers, L. M., van Hunnik, A., Kuiper, M., Klersy, C., Auricchio, A., & Prinzen, F. W. (2009) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.108.846022 · Cited by 123 · see citing works
Strocchi, M., Augustin, C. M., Gsell, M. A. F., Karabelas, E., Neic, A., Gillette, K., Razeghi, O., Prassl, A. J., Vigmond, E. J., Behar, J. M., et al. (2020) · PLoS ONE · doi:10.1371/journal.pone.0235145 · Cited by 112 · see citing works
Self-citationOno, N., Yamaguchi, T., Ishikawa, H., Arakawa, M., Takahashi, N., Saikawa, T., & Shimada, T. (2009) · Archivum histologicum japonicum · doi:10.1679/aohc.72.139 · Cited by 111 · see citing works
Sieniewicz, B., Gould, J., Porter, B., Sidhu, B. S., Teall, T., Webb, J., Carr-White, G., & Rinaldi, C. A. (2018) · Heart Failure Reviews · doi:10.1007/s10741-018-9734-8 · Cited by 105 · see citing works
Sieniewicz, B., Betts, T. R., James, S., Turley, A., Butter, C., Seifert, M., Boersma, L. V. A., Riahi, S., Neužil, P., Biffi, M., et al. (2020) · Heart Rhythm · doi:10.1016/j.hrthm.2020.03.002 · Cited by 84 · see citing works
Ginks, M., Shetty, A., Lambiase, P. D., Duckett, S. G., Bostock, J., Peacock, J. L., Rhode, K., Bucknall, C. A., Gill, J. S., Taggart, P. I., et al. (2012) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.111.967505 · Cited by 76 · see citing works
Strocchi, M., Lee, A. W. C., Neic, A., Bouyssier, J., Gillette, K., Plank, G., Elliott, M. K., Gould, J., Behar, J. M., Sidhu, B., et al. (2020) · Heart Rhythm · doi:10.1016/j.hrthm.2020.06.028 · Cited by 73 · see citing works
Self-citationThe Role of Purkinje-Myocardial Coupling during Ventricular Arrhythmia: A Modeling Study
Behradfar, E., Nygren, A., & Vigmond, E. J. (2014) · PLoS ONE · doi:10.1371/journal.pone.0088000 · Cited by 72 · see citing works
Gillette, K. K., Gsell, M. A. F., Bouyssier, J., Prassl, A. J., Neic, A., Vigmond, E. J., & Plank, G. (2021) · Annals of Biomedical Engineering · doi:10.1007/s10439-021-02825-9 · Cited by 71 · see citing works
Costa, C. M., Neic, A., Kerfoot, E., Porter, B., Sieniewicz, B., Gould, J., Sidhu, B. S., Chen, Z., Plank, G., Rinaldi, C. A., et al. (2019) · Heart Rhythm · doi:10.1016/j.hrthm.2019.03.027 · Cited by 65 · see citing works
Behar, J. M., Jackson, T., Hyde, E., Claridge, S., Gill, J. S., Bostock, J., Sohal, M., Porter, B., O'Neill, M. D., Razavi, R., et al. (2016) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2016.04.006 · Cited by 62 · see citing works
Bryant, A. R., Wilton, S. B., Lai, M. P., & Exner, D. V. (2013) · Journal of Electrocardiology · doi:10.1016/j.jelectrocard.2012.12.003 · Cited by 57 · see citing works
Hyde, E., Behar, J. M., Claridge, S., Jackson, T., Lee, A., Remme, E. W., Sohal, M., Plank, G., Razavi, R., Rinaldi, C. A., et al. (2015) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.115.002677 · Cited by 53 · see citing works
Bazoukis, G., Naka, K. Κ., Alsheikh-Ali, A. A. A., Tse, G., Letsas, Κ. P., Korantzopoulos, P. G., Liu, T., Yeung, C., Efremidis, M., Tsioufis, K. P., et al. (2019) · Heart Failure Reviews · doi:10.1007/s10741-019-09839-5 · Cited by 44 · see citing works
A personalized real-time virtual model of whole heart electrophysiology
Gillette, K. K., Gsell, M. A. F., Strocchi, M., Grandits, T., Neic, A., Manninger, M., Scherr, D., Roney, C. H., Prassl, A. J., Augustin, C. M., et al. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2022.907190 · Cited by 41 · see citing works
Self-citationPadeletti, L., Pieragnoli, P., Ricciardi, G., Innocenti, L., Checchi, L., Padeletti, M., Michelucci, A., Picariello, F., & Valsecchi, S. (2016) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.115.003793 · Cited by 37 · see citing works
Pacing Without Wires: Leadless Cardiac Pacing.
Bernard, M. L. (2016) · PubMed Central · Cited by 30 · see citing works
Elliott, M. K., Vergara, P., Wijesuriya, N., Mehta, V. S., Bosco, P., Jacon, P., Lee, M. S., Taloni, S., Niederer, S., Alison, J., et al. (2022) · Heart Rhythm · doi:10.1016/j.hrthm.2022.07.017 · Cited by 30 · see citing works
Wijesuriya, N., Elliott, M. K., Mehta, V. S., Sidhu, B. S., Behar, J. M., Niederer, S., & Rinaldi, C. A. (2022) · Heart Rhythm · doi:10.1016/j.hrthm.2022.02.018 · Cited by 27 · see citing works
Optimal CRT Implantation—Where and How To Place the Left-Ventricular Lead?
Butter, C., Georgi, C., & Stockburger, M. A. (2021) · Current Heart Failure Reports · doi:10.1007/s11897-021-00528-9 · Cited by 25 · see citing works
Elliott, M. K., Jacon, P., Sidhu, B. S., Jarrett-Smith, L., Mehta, V. S., Gould, J., Lee, A., Niederer, S., Defaye, P., & Rinaldi, C. A. (2021) · European Heart Journal - Case Reports · doi:10.1093/ehjcr/ytab379 · Cited by 23 · see citing works
Strocchi, M., Gillette, K., Neic, A., Elliott, M. K., Wijesuriya, N., Mehta, V., Vigmond, E. J., Plank, G., Rinaldi, C. A., & Niederer, S. A. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2022.1011566 · Cited by 16 · see citing works
Self-citationLin, J., Dai, Y., Wang, H., Li, Y., Chen, K., & Zhang, S. (2019) · HeartRhythm Case Reports · doi:10.1016/j.hrcr.2019.10.007 · Cited by 13 · see citing works
Programmed versus Effective VV Delay during CRT Optimization: When What You See Is Not What You Get
Bogaard, M. D., Meine, M., & Doevendans, P. A. (2013) · Pacing and Clinical Electrophysiology · doi:10.1111/pace.12065 · Cited by 7 · see citing works
Flagged first, then by citations
1 of the 37 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- Arnold A. D. Shun-Shin M. J. Keene D. Howard J. P. Afzal Sohaib S. M. Wright I. J. (2018). His resynchronization therapy vs. biventricular pacing for heart failure with LBBB: A within-patient comparison of effects on acute haemodynamic function and ventricular activation. Europace 20 (Suppl. 4), iv25. 10.1093/europace/euy201.001 · DOI
Cited by
Sorted by citations
Credibility assessment of in silico clinical trials for medical devices
Pathmanathan, P., Aycock, K., Badal, A., Bighamian, R., Bodner, J., Craven, B. A., & Niederer, S. (2024) · PLOS Computational Biology · doi:10.1371/journal.pcbi.1012289 · Cited by 62 · see citing works
“These models were used in [41–43] to study the efficacy of different cardiac resynchronization therapy (CRT) pacing protocols for heart failure patients with left bundle branch block (LBBB).”
Computational Modelling Enabling In Silico Trials for Cardiac Physiologic Pacing
Strocchi, M., Wijesuriya, N., Mehta, V. S., de Vere, F., Rinaldi, C. A., & Niederer, S. (2023) · Journal of Cardiovascular Translational Research · doi:10.1007/s12265-023-10453-y · Cited by 10 · see citing works
Self-citationStrocchi, M., Samways, J., Naraen, A., Ali, N., Shun-Shin, M. J., Gillette, K. K., Rinaldi, C. A., Arnold, A. D., Plank, G., Vigmond, E. J., et al. (2025) · EP Europace · doi:10.1093/europace/euaf089 · Cited by 9 · see citing works
Self-citationCao, B., Zhang, N., Fu, Z., Dong, R., Chen, T., Zhang, W., Tong, L., Wang, Z., Ma, M., Song, Z., et al. (2023) · Reviews in Cardiovascular Medicine · doi:10.31083/j.rcm2412351 · Cited by 5 · see citing works
Individual hearts: computational models for improved management of cardiovascular disease
van Osta, N., van Loon, T., & Lumens, J. (2025) · Heart · doi:10.1136/heartjnl-2024-324177 · Cited by 3 · see citing works
Nesterova, T., Kabak, V. Y., Lebedev, D. S., & Solovyova, O. E. (2024) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2024-6194 · Cited by 3 · see citing works
Left bundle branch area pacing versus endocardial resynchronization in patients with heart failure
Díaz, J. C., Bastidas, O., Aristizábal, J. M., Marín, J. E., Niño, C. D., Moreno, S., Ruíz, L. M., Cáceres-Acosta, M. F., Jaraba, E., López-Cabanillas, N., et al. (2024) · Journal of Cardiovascular Electrophysiology · doi:10.1111/jce.16479
Modeling of the cardiac conduction system
Vigmond, E. J. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-24142-0.00006-0
- Authors
- Strocchi, M., Wijesuriya, N., Elliott, M. K., Gillette, K., Neic, A., Mehta, V., Vigmond, E. J., Plank, G., Rinaldi, C. A., & Niederer, S. A.
- Affiliations
- King's College London (GB)
- Medical University of Graz (AT)
- Centre National de la Recherche Scientifique (FR)
- Corresponding author
- Strocchi, Marina
- ORCID
- Venue
- Frontiers in Physiology
- Publisher
- Frontiers Media SA
- Published
- 2022-12-14
- Volume
- 13
- Pages
- 1049214-1049214
- ISSN
- 1664-042X (ISSN-L)
- PMC
- PMC9794756
- OpenAlex
- W4311329351
- Cited by
- 8
- References
- 37
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 2
- FWCI
- 1.22
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Physiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Engineering and Physical Sciences Research Council (WT 203148/Z/16/Z EP/P01268X/1)
- Wellcome (WT 203148/Z/16/Z)
- National Institutes of Health (R01-HL152256)
- European Research Council (864055)
- British Heart Foundation (RG/20/4/34803)
- Agence Nationale de la Recherche (ANR-10-IAHU-04)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- left bundle branch block, leadless pacing, cardiac resynchronization therapy, ventricular synchrony, atrioventricular delay optimization, computational cardiac modeling, ventricular activation time, pacing site selection, atrial fibrillation
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
