Conduction system pacing in a pediatric population: a case series

Background: Left bundle branch area pacing (LBBAP) offers physiological pacing with potential advantages over right ventricular (RV) pacing, particularly in children. However, data on LBBAP in pediatric populations are scarce. Objective: This study aimed to assess the feasibility and safety of LBBAP in children by reporting 6 cases done successfully. Methods: Six children (four males, two females), aged 2 to 16 years, underwent LBBAP between December 2022 and January 2024 at the American Univeristy of Beirut Medical Center (AUBMC). The implantation procedure followed established techniques. Baseline characteristics, echocardiographic measurements, and pacing parameters were recorded. Results: All six cases fulfilled the criteria for LBBAP. Successful LBBAP was achieved in all cases. Median weight is 20.5 kg, with three patients under 5 years old. Baseline left ventricular ejection fraction (LVEF) was normal in 4 cases, with two exhibiting 52%. The interventricular septal thickness averaged 4.5 mm. No major complications were encountered during follow-up. Conclusion: Left bundle branch area pacing might be a promising alternative to conventional RV pacing, offering potential advantages over traditional pacing methods. Further research is needed to fully elucidate its efficacy and long-term benefits in pediatric populations.