Clinical Prediction Model for Unsuccessful Left Bundle Branch Area Pacing

INTRODUCTION: Left bundle branch area pacing (LBBAP) has rapidly become a preferred form of cardiac physiologic pacing; however, predictors of unsuccessful implantation remain unclear. METHODS AND RESULTS: ; p = 0.01) as independent predictors of unsuccessful LBBAP. A model integrating these variables demonstrated strong discrimination (area under the curve [AUC] = 0.84), which was confirmed by bootstrap validation (AUC = 0.85; 95% confidence interval = 0.76-0.93). A nomogram was constructed to enable individualized risk estimation. CONCLUSION: NIVCD, septal hypertrophy, and right atrial enlargement are independent predictors of LBBAP failure. The resulting validated prediction model and nomogram provide individualized pre-procedural risk estimation and may assist in optimizing patient selection and procedural strategy.