Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (891 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
A form of heart block in which the electrical stimulation of heart ventricles is interrupted at either one of the branches of bundle OF HIS thus preventing the simultaneous depolarization of the two ventricles.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Block, Bundle-Branch; Blocks, Bundle-Branch; Bundle-Branch Blocks; Bundle Branch Block; Block, Bundle Branch; Blocks, Bundle Branch; Branch Block, Bundle; Branch Blocks, Bundle.
Where it fits in the MeSH classification
- Broader topics
- Heart Block
- See also
- Bundle of His
Related concepts
- Heart Ventricles
- Bundle
Research landscape
PubMed indexes 10,487 records tagged with the MeSH heading “Bundle-Branch Block” (counts retrieved 2026-10-29). 1,457 of them (13.9%) were published from 2020 onward, and the busiest period so far is through 1999 with 5,067 records.
Reviews account for 766 records (7.3%) and meta-analyses for 38. Randomized controlled trials number 156 (1.5%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 5,067 |
| 2000-2009 | 1,942 |
| 2010-2019 | 2,021 |
| 2020 onward | 1,457 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 766 | 7.3% |
| Meta-analyses | 38 | 0.4% |
| Randomized controlled trials | 156 | 1.5% |
Method: PubMed query "Bundle-Branch Block"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.
Reading the evidence in cardiovascular medicine
Cardiovascular medicine has an unusually large body of randomized trials, so the type of outcome matters: hard clinical events such as death, heart attack and stroke carry more weight than changes in blood pressure, cholesterol or imaging markers that only predict risk. Observational studies can show associations but are confounded by age, lifestyle and other illness. Check whether a result is about prevention or treatment, the baseline risk of participants, and the absolute rather than only the relative size of any benefit.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
His Resynchronization Versus Biventricular Pacing in Patients With Heart Failure and Left Bundle Branch Block [1]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundHis bundle pacing is a new method for delivering cardiac resynchronization therapy (CRT).
- Closing excerpt
- 6 ms; p ConclusionsHis resynchronization delivers better ventricular resynchronization, and greater improvement in hemodynamic parameters, than biventricular pacing.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (207 words)
BackgroundHis bundle pacing is a new method for delivering cardiac resynchronization therapy (CRT).ObjectivesThe authors performed a head-to-head, high-precision, acute crossover comparison between His bundle pacing and conventional biventricular CRT, measuring effects on ventricular activation and acute hemodynamic function.MethodsPatients with heart failure and left bundle branch block referred for conventional biventricular CRT were recruited. Using noninvasive epicardial electrocardiographic imaging, the authors identified patients in whom His bundle pacing shortened left ventricular activation time. In these patients, the authors compared the hemodynamic effects of His bundle pacing against biventricular pacing using a high-multiple repeated alternation protocol to minimize the effect of noise, as well as comparing effects on ventricular activation.ResultsIn 18 of 23 patients, left ventricular activation time was significantly shortened by His bundle pacing. Seventeen patients had a complete electromechanical dataset. In them, His bundle pacing was more effective at delivering ventricular resynchronization than biventricular pacing: greater reduction in QRS duration (-18.6 ms; 95% confidence interval [CI]: -31.6 to -5.7 ms; p = 0.007), left ventricular activation time (-26 ms; 95% CI: -41 to -21 ms; p = 0.002), and left ventricular dyssynchrony index (-11.2 ms; 95% CI: -16.8 to -5.6 ms; p ConclusionsHis resynchronization delivers better ventricular resynchronization, and greater improvement in hemodynamic parameters, than biventricular pacing.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 30545450 · DOI · PMC6290113
Impact of Cusp-Overlap View for TAVR with Self-Expandable Valves on 30-Day Conduction Disturbances [2]
Abstract reading summary — source excerpts
- Opening excerpt
- Methods and resultsWe retrospectively compared 257 consecutive patients undergoing TAVR with self-expandable valves using either CON (n = 101) or COVL (n = 156) in four intermediate/low volume centers.
- Closing excerpt
- ConclusionUsing the COVL view for implantation, we achieved a significant reduction of the LBBB and PPMI rate after TAVR in comparison with the traditional CON view, without compromising the TAVR outcomes when using self-expandable prostheses.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (135 words)
Methods and resultsWe retrospectively compared 257 consecutive patients undergoing TAVR with self-expandable valves using either CON (n = 101) or COVL (n = 156) in four intermediate/low volume centers. There were no significant differences in baseline characteristics between the groups. The 30-day incidence of new-onset LBBB (12.9% vs. 5.8%; p=0.05) and PPMI rate (17.8% vs. 6.4%; p=0.004) was significantly lower when using the COVL implantation view. There was no difference between the CON and COVL groups in 30-day incidence of death (4.9% vs. 2.6%), any stroke (0% vs. 0.6%), and the need for surgical aortic valve replacement (0% for both groups).ConclusionUsing the COVL view for implantation, we achieved a significant reduction of the LBBB and PPMI rate after TAVR in comparison with the traditional CON view, without compromising the TAVR outcomes when using self-expandable prostheses.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 34007249 · DOI · PMC8099519
Multicenter Hemodynamic Assessment of the LOT-CRT Strategy: When Does Combining Left Bundle Branch Pacing and Coronary Venous Pacing Enhance Resynchronization?: Primary Results of the CSPOT Study [3]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundLeft bundle branch area pacing (LBBAP) may be an alternative to biventricular pacing (BVP) for cardiac resynchronization therapy (CRT).
- Closing excerpt
- gov; Unique identifier: NCT04905290.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (280 words)
BackgroundLeft bundle branch area pacing (LBBAP) may be an alternative to biventricular pacing (BVP) for cardiac resynchronization therapy (CRT). We sought to compare the acute hemodynamic and ECG effects of LBBAP, BVP, and left bundle-optimized therapy CRT (LOT-CRT) in CRT candidates with advanced conduction disease.MethodsIn this multicenter study, 48 patients with either nonspecific interventricular conduction delay (n=29) or left bundle branch block (n=19) underwent acute hemodynamic testing to determine the change in left ventricular pressure maximal first derivative (LV dP/dtmax) from baseline atrial pacing to BVP, LBBAP, or LOT-CRT.ResultsAtrioventricular-optimized increases in LV dP/dtmax for LOT-CRT (mean, 25.8% [95% CI, 20.9%-30.7%]) and BVP (26.4% [95% CI, 20.2%-32.6%]) were greater than unipolar LBBAP (19.3% [95% CI, 15.0%-23.7%]) or bipolar LBBAP (16.4% [95% CI, 12.7%-20.0%]; P≤0.005). QRS shortening was greater in LOT-CRT (29.5 [95% CI, 23.4-35.6] ms) than unipolar LBBAP (11.9 [95% CI, 6.1-17.7] ms), bipolar LBBAP (11.7 ms [95% CI, 6.4-17.0]), or BVP (18.5 [95% CI, 11.0-25.9] ms), all P≤0.005. Compared with patients with left bundle branch block, patients with interventricular conduction delay experienced less QRS reduction (P=0.026) but similar improvements in LV dP/dtmax (P=0.29). Bipolar LBBAP caused anodal capture in 54% of patients and resulted in less LV dP/dtmax improvement than unipolar LBBAP (18.6% versus 23.7%; PP=0.031) and success of LBBAP (PP/dtmax improvement and 20.8 (12.8-28.8) ms greater QRS shortening than LBBAP in subjects with QRS ≥171 ms and deep septal pacing capture type.ConclusionsIn a CRT cohort with advanced conduction disease, LOT-CRT and BVP provided greater acute hemodynamic benefit than LBBAP. Subjects with wider QRS or deep septal pacing are more likely to benefit from the addition of a left ventricular coronary vein lead to implement LOT-CRT.RegistrationURL: https://www.clinicaltrials.gov; Unique identifier: NCT04905290.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 39440428 · DOI · PMC11575906
Long-Term Outcomes of Left Bundle-Branch Pacing vs Biventricular Pacing in Heart Failure: The HeartSync-LBBP Randomized Clinical Trial [4]
Abstract reading summary — source excerpts
- Opening excerpt
- ImportanceLeft bundle-branch pacing (LBBP) has been proposed as an alternative to biventricular pacing (BiVP) for patients with heart failure with left bundle-branch block (LBBB).
- Closing excerpt
- Trial registrationChinese Clinical Trial Registry identifier: ChiCTR2000036554.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (269 words)
ImportanceLeft bundle-branch pacing (LBBP) has been proposed as an alternative to biventricular pacing (BiVP) for patients with heart failure with left bundle-branch block (LBBB). However, robust clinical evidence from randomized clinical trials is lacking.ObjectiveTo evaluate the long-term clinical outcomes of LBBP and BiVP.Design, setting, and participantsThis multicenter, prospective, randomized clinical trial enrolled 200 patients at 6 centers in China with a left ventricular ejection fraction (LVEF) of 35% or less and LBBB from October 2020 to March 2022. This study was took place from October 2020 to September 2024. These data were analyzed September 2024 to December 2024.InterventionsPatients were randomly assigned in a 1:1 ratio to receive either LBBP or BiVP.Main outcomes and measuresThe primary end point was the time to death from any cause or heart failure hospitalization (HFH). The secondary end points included all-cause death, HFH, echocardiographic response (absolute increase in LVEF ≥5%), and super response (absolute increase in LVEF ≥15% or improvement of LVEF to ≥50%) rates.ResultsOf the 200 included patients, 136 were male and 64 were female. The success rate was 98% in the LBBP group and 94% in the BiVP group (P = .28). The median follow-up duration was 36 (range, 33-39) months. The primary end point of time to death or HFH was significantly lower in the LBBP group compared with BiVP (8% vs 28%; hazard ratio [HR], 0.26; 95% CI, 0.12-0.57; P Conclusions and relevanceIn this study, LBBP was superior to BiVP in reducing the risk of death or HFH in patients with LBBB and severely reduced LVEF. Further trials are warranted in this patient population.Trial registrationChinese Clinical Trial Registry identifier: ChiCTR2000036554.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41811342 · DOI · PMC12980356
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Defining left bundle branch block in the era of cardiac resynchronization therapy [5]
- Research article Brugada syndrome: report of the second consensus conference [6]
- Research article The Brugada syndrome: ionic basis and arrhythmia mechanisms [7]
- Research article His Bundle Pacing [8]
- Research article Impact of New-Onset Left Bundle Branch Block and Periprocedural Permanent Pacemaker Implantation on Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis [9]
- Research article Proposed diagnostic criteria for the Brugada syndrome [10]
References
- Arnold AD, Shun-Shin MJ, Keene D, Howard JP, Sohaib SMA, Wright IJ, et al.. His Resynchronization Versus Biventricular Pacing in Patients With Heart Failure and Left Bundle Branch Block. . 2018. PMID 30545450 · DOI · PMC6290113
- Mendiz OA, Noč M, Fava CM, Gutiérrez Jaikel LA, Sztejfman M, Pleskovič A, et al.. Impact of Cusp-Overlap View for TAVR with Self-Expandable Valves on 30-Day Conduction Disturbances. . 2021. PMID 34007249 · DOI · PMC8099519
- Jastrzębski M, Foley P, Chandrasekaran B, Whinnett Z, Vijayaraman P, Upadhyay GA, et al.. Multicenter Hemodynamic Assessment of the LOT-CRT Strategy: When Does Combining Left Bundle Branch Pacing and Coronary Venous Pacing Enhance Resynchronization?: Primary Results of the CSPOT Study. . 2024. PMID 39440428 · DOI · PMC11575906
- Chen X, Liu X, Li R, Wang Z, Liang Y, Zhang L, et al.. Long-Term Outcomes of Left Bundle-Branch Pacing vs Biventricular Pacing in Heart Failure: The HeartSync-LBBP Randomized Clinical Trial. . 2026. PMID 41811342 · DOI · PMC12980356
- Strauss DG, Selvester RH, Wagner GS. Defining left bundle branch block in the era of cardiac resynchronization therapy. Am J Cardiol. 2011. PMID 21376930 · DOI
- Antzelevitch C, Brugada P, Borggrefe M, Brugada J, Brugada R, Corrado D, et al.. Brugada syndrome: report of the second consensus conference. Heart Rhythm. 2005. PMID 15898165 · DOI
- Antzelevitch C. The Brugada syndrome: ionic basis and arrhythmia mechanisms. J Cardiovasc Electrophysiol. 2001. PMID 11232628 · DOI
- Vijayaraman P, Chung MK, Dandamudi G, Upadhyay GA, Krishnan K, Crossley G, et al.. His Bundle Pacing. J Am Coll Cardiol. 2018. PMID 30115232 · DOI
- Regueiro A, Abdul-Jawad Altisent O, Del Trigo M, Campelo-Parada F, Puri R, Urena M, et al.. Impact of New-Onset Left Bundle Branch Block and Periprocedural Permanent Pacemaker Implantation on Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis. Circ Cardiovasc Interv. 2016. PMID 27169577 · DOI
- Wilde AA, Antzelevitch C, Borggrefe M, Brugada J, Brugada R, Brugada P, et al.. Proposed diagnostic criteria for the Brugada syndrome. Eur Heart J. 2002. PMID 12448445 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-29.
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Evidence strength
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