Feasibility and Safety of Left Bundle Branch Pacing in Nonagenarians: A Single Center Observational Study.

BACKGROUND

Left bundle branch pacing (LBBP) is emerging as a physiological pacing strategy. However, data on its feasibility and safety in nonagenarians (≥90 years) with symptomatic bradycardia are limited. This study aims to evaluate the outcomes of LBBP in this frail, high-risk population.

METHODS

A retrospective analysis was conducted on 8 patients aged 90 and older who underwent LBBP between December 2023 and December 2024. Procedural outcomes, complications, and pacing parameters were assessed.

RESULTS

LBBP was successfully performed in 8 patients (mean age 93 ± 2 years, mean Clinical Frailty Score 5). The pacing indications included atrioventricular block and sinus node dysfunction. The mean left ventricular activation time was 75 ± 8 ms. At a median follow-up of 6 weeks, pacing parameters remained stable with no evidence of lead displacement, haematoma, or infection. There were no immediate procedural complications.

CONCLUSIONS

LBBP appears to be a feasible and safe physiological pacing strategy in nonagenarians with symptomatic bradycardia. Further studies are needed to confirm the long-term outcomes of LBBP in elderly patients.