Sex‐Based Differences in Left Bundle Branch Capture During Left Bundle Branch Area Pacing

Despite innate differences in QRS duration between males and females, no recommendations have been established to assess for left bundle branch (LBB) capture across different sexes in patients undergoing LBB area pacing (LBBAP). To this end, we performed a retrospective study analyzing postimplant ECGs from 222 patients (143 males/79 females). R-wave peak times (RWPTs), traditionally used to identify LBB capture, were noted to be ∼7 ms shorter in females vs. males, with the differences resolved when accounting for smaller size of female hearts despite no correlation between RWPT and body/heart size. These results argue towards establishing sex-based cutoffs for LBB capture.

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Publication Details

Journal
Pacing and Clinical Electrophysiology
Published
2026-02-25
DOI
https://doi.org/10.1111/pace.70181
Primary Topic
Cardiac pacing and defibrillation studies
Type
article
Field-Weighted Citation Impact
0.00
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article

Sex‐Based Differences in Left Bundle Branch Capture During Left Bundle Branch Area Pacing

Brett D. Atwater, John G.F. Cleland, Ilya Y. Shadrin, Donald D. Hegland et al.
Pacing and Clinical Electrophysiology
Cardiac pacing and defibrillation studies
article

Sex‐Based Differences in Left Bundle Branch Capture During Left Bundle Branch Area Pacing

Brett D. Atwater, John G.F. Cleland, Ilya Y. Shadrin, Donald D. Hegland, Albert Y. Sun, Zak Loring, Kevin Jackson, Sara Coles, Claus Graff, Sean D. Pokorney, Daniel J Friedman, Camille G Frazier-Mills, Jonathan P Piccini, James P Daubert
article en

Abstract

Despite innate differences in QRS duration between males and females, no recommendations have been established to assess for left bundle branch (LBB) capture across different sexes in patients undergoing LBB area pacing (LBBAP). To this end, we performed a retrospective study analyzing postimplant ECGs from 222 patients (143 males/79 females). R-wave peak times (RWPTs), traditionally used to identify LBB capture, were noted to be ∼7 ms shorter in females vs. males, with the differences resolved when accounting for smaller size of female hearts despite no correlation between RWPT and body/heart size. These results argue towards establishing sex-based cutoffs for LBB capture.

Pacing and Clinical Electrophysiology
Inova Fairfax Hospital (US), Clinical Research Institute (US), Duke University Hospital (US), Aalborg University (DK)
Gender equality
Openalex Percentile: Top 45%
Cardiac pacing and defibrillation studies
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