What does Non-Selective (NS-LBBAP) pacing capture?

• A. Only the LBB
• B. Only local ventricular septal myocardium
• C. Both the LBB and local ventricular septal myocardium
• D. Neither the LBB nor local myocardium

Answer: (C)

Non-Selective Left Bundle Branch Area Pacing (NS-LBBAP) is designed to capture both the Left Bundle Branch (LBB) and the local ventricular septal myocardium. This is significant in the context of cardiac conduction, as capturing both areas allows for more effective electrical stimulation of the heart.

When pacing occurs in the non-selective area, the electrical impulse stimulated from the pacing lead can propagate not only through the LBB but also into the surrounding myocardium. This leads to a more synchronous ventricular contraction, improving cardiac function and optimizing hemodynamics.

The ability to stimulate the adjacent ventricular septal myocardium along with the LBB enhances the overall conduction pattern and helps achieve a more physiologic pacing response. By successfully activating both regions, NS-LBBAP aims to correct the conduction abnormalities often seen in patients with bundle branch block, thereby reducing the risks associated with traditional pacing methods that may only target a single area.