scispace - formally typeset
Search or ask a question
Journal ArticleDOI

Left bundle branch pacing compared to left ventricular septal myocardial pacing increases interventricular dyssynchrony but accelerates left ventricular lateral wall depolarization.

TL;DR: In this article, the authors compared different pacing techniques using ultra-high-frequency electrocardiography (UHF-ECG) and found that nsLBBp resulted in larger e-DYS than did LVSP and nsHBp.
About: This article is published in Heart Rhythm.The article was published on 2021-08-01 and is currently open access. It has received 49 citations till now. The article focuses on the topics: Electrocardiography.
Citations
More filters
Journal ArticleDOI
TL;DR: This prospective study sought to establish a differentiation algorithm to confirm LBBP and found that left bundle branch pacing is a new near‐physiological pacing modality.
Abstract: Left bundle branch pacing (LBBP) is a new near‐physiological pacing modality. Distinguishing left ventricular septal only pacing (LVSP) from nonselective LBBP still needs clarification. This prospective study sought to establish a differentiation algorithm to confirm LBBP.

15 citations

Journal ArticleDOI
01 Apr 2023-Europace
TL;DR: In this paper , the authors provide a framework for physicians who wish to start CSP implantation, or who want to improve their technique, as well as a standardization of the procedure and to provide a guidance for physicians.
Abstract: Abstract Conduction system pacing (CSP) has emerged as a more physiological alternative to right ventricular pacing and is also being used in selected cases for cardiac resynchronization therapy. His bundle pacing was first introduced over two decades ago and its use has risen over the last five years with the advent of tools which have facilitated implantation. Left bundle branch area pacing is more recent but its adoption is growing fast due to a wider target area and excellent electrical parameters. Nevertheless, as with any intervention, proper technique is a prerequisite for safe and effective delivery of therapy. This document aims to standardize the procedure and to provide a framework for physicians who wish to start CSP implantation, or who wish to improve their technique.

12 citations

Journal ArticleDOI
TL;DR: In this article , the authors reviewed electrocardiography-based and intracardiac electrogram-based criteria to confirm LBB capture and their overall accuracy and concluded that the criteria for differentiating LBBP from septal pacing has not been validated in large trials.

11 citations

Journal ArticleDOI
TL;DR: In this article , the authors compared left bundle branch area pacing (LBBaP) with HBP for bradyarrhythmia with 786 patients (n = 442 receiving LBP and n = 344 receiving HBP) and found that LBBaPs appeared to result in increased R wave amplitudes (at implant: MD 9.84 mV, 95% confidence interval [CI] 7.61 to 12.06 mV; at follow-up: MD 7.62 mV.
Abstract: Although His bundle pacing (HBP) can provide a physiologic ventricular activation pattern, it has disadvantages such as the difficulty of lead implantation, reduced R wave amplitudes, and high and unstable pacing thresholds. Recent studies have demonstrated that left bundle branch area pacing (LBBaP) might overcome these deficiencies. A total of 7 nonrandomized controlled studies including 786 patients (n = 442 receiving LBBaP and n = 344 receiving HBP) with bradyarrhythmia were evaluated. Compared with HBP, LBBaP appeared to result in increased R wave amplitudes (at implant: MD 9.84 mV, 95% confidence interval [CI] 7.61 to 12.06 mV; at follow-up: MD 7.62 mV, 95% CI 6.73 to 8.50 mV), lowered capture thresholds (at implant: MD -0.73 V, 95% CI -0.81 to -0.64 V; at follow-up: MD -0.71 V, 95% CI -0.92 to -0.50 V), shortened procedure times (MD -16.70 minutes, 95% CI -26.51 to -6.90 minutes) and fluoroscopic durations (MD -6.16 min, 95% CI -8.28 to -4.03 minutes), and increased success rates (odds ratio 2.14, 95% CI 1.23 to 3.74); all of these differences were significant. However, paced QRS durations, the lead impedance at implantation and follow-up, and incidence of lead-related complications such as lead dislodgement did not significantly differ between LBBaP and HBP. In conclusion, current evidence suggests that LBBaP is a potential alternative to HBP as a pacing modality with which to maintain an ideal physiologic pattern of ventricular activation through native His-Purkinje system stimulation.

8 citations

References
More filters
Journal ArticleDOI
TL;DR: The case shows a novel pacing strategy for patients with BBB that affects many patients with heart failure, and demonstrates the feasibility of pacing the left bundle branch (LBB) immediately beyond the conduction block to functionally restore the impaired His-Purkinje conduction system.

450 citations

Journal ArticleDOI
TL;DR: In this article, a set of definitions encompassing the different forms of HBP as well as a standardized approach to gathering data end points to ensure consistency in reported outcomes are defined and discussed.

257 citations

Journal ArticleDOI
TL;DR: In this paper, left bundle branch branch pacing (LBBP) is used for pacing and has been observed to have low and stable pacing thresholds in prior small short-term studies.
Abstract: Background: Left bundle branch pacing (LBBP) is a novel pacing method and has been observed to have low and stable pacing thresholds in prior small short-term studies. The objective of this study w...

144 citations

Journal ArticleDOI
TL;DR: Permanent placement of an LVS pacing lead by transvenous approach through the interventricular septum is feasible in patients and could serve as an alternative and hemodynamically preferable approach for antibradycardia pacing.
Abstract: Background— Left ventricular septal (LVS) pacing reduces ventricular dyssynchrony and improves cardiac function relative to right ventricular apex (RVA) pacing in animals. We aimed to establish permanent placement of an LVS pacing lead in patients using a transvenous approach through the interventricular septum. Methods and Results— Ten patients with sinus node dysfunction scheduled for dual-chamber pacemaker implantation were prospectively enrolled. A custom pacing lead with extended helix was introduced via the left subclavian vein and, after positioning against the right ventricular septum (RVS) using a preshaped guiding catheter, driven through the interventricular septum to the LVS. The acute hemodynamic effect of RVA, RVS, and LVS pacing was evaluated by invasive LVdP/dtmax measurements. The lead was successfully delivered to the LVS in all patients. Procedure time and fluoroscopy time shortened with experience. QRS duration was shorter during LVS pacing (144±20 ms) than during RVA (172±33 ms; P =0.02 versus LVS) and RVS pacing (165±17 ms; P =0.004 versus LVS). RVA and RVS pacing reduced LVdP/dtmax compared with baseline atrial pacing (−7.1±4.1% and −6.9±4.3%, respectively), whereas LVS pacing maintained LVdP/dtmax at baseline level (1.0±4.3%; P =0.001 versus RVA and RVS). R-wave amplitude and pacing threshold were 12.2±6.7 mV and 0.5±0.2 V at implant and remained stable during 6-month follow-up without lead-related complications. Conclusions— Permanent placement of an LVS pacing lead by transvenous approach through the interventricular septum is feasible in patients. LVS pacing preserves acute left ventricular pump function. This new pacing method could serve as an alternative and hemodynamically preferable approach for antibradycardia pacing.

104 citations

Related Papers (5)