Journal ArticleDOI
Programmed deep septal stimulation: A novel maneuver for the diagnosis of left bundle branch capture during permanent pacing
Marek Jastrzębski,Paweł Moskal,Agnieszka Bednarek,Agnieszka Bednarek,Grzegorz Kiełbasa,Aleksander Kusiak,Aleksander Kusiak,Tomasz Sondej,Adam Bednarski,Pugazhendhi Vijayaraman,Danuta Czarnecka +10 more
TLDR
Permanent deep septal stimulation with capture of the left bundle branch (LBB) enables maintenance/restoration of the physiological activation of theleft ventricle.Abstract:
Introduction Permanent deep septal stimulation with capture of the left bundle branch (LBB) enables maintenance/restoration of the physiological activation of the left ventricle. However, it is almost always accompanied by the simultaneous engagement of the local septal myocardium, resulting in a fused (nonselective) QRS complex, therefore, confirmation of LBB capture remains difficult. Methods We hypothesized that programmed extrastimulus technique can differentiate nonselective LBB capture from myocardial-only capture as the effective refractory period (ERP) of the myocardium is different from the ERP of the LBB. Consecutive patients undergoing pacemaker implantation underwent programmed stimulation delivered from the lead implanted in a deep septal position. Responses to programmed stimulation were categorized on the basis of sudden change in the QRS morphology of the extrastimuli, observed when ERP of LBB or myocardium was encroached upon, as: "myocardial," "selective LBB," or nondiagnostic (unequivocal change of QRS morphology). Results Programmed deep septal stimulation was performed 269 times in 143 patients; in every patient with the use of a basic drive train of 600 milliseconds and in 126 patients also during intrinsic rhythm. The average septal-myocardial refractory period was shorter than the LBB refractory period: 263.0 ± 34.4 vs 318.0 ± 37.4 milliseconds. Responses diagnostic for LBB capture ("myocardial" or "selective LBB") were observed in 114 (79.7%) of patients. Conclusions A novel maneuver for the confirmation of LBB capture during deep septal stimulation was developed and found to enable definitive diagnosis by visualization of both components of the paced QRS complex: selective paced LBB QRS and myocardial-only paced QRS.read more
Citations
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Journal ArticleDOI
Left Bundle Branch Area Pacing for Cardiac Resynchronization Therapy: Results From the International LBBAP Collaborative Study Group.
Pugazhendhi Vijayaraman,ShunmugaSundaram Ponnusamy,Óscar Cano,Parikshit S. Sharma,Angela Naperkowski,Faiz A. Subsposh,Paweł Moskal,Agnieszka Bednarek,Alexander R. Dal Forno,Wilson Young,Sudip Nanda,Dominik Beer,Bengt Herweg,Marek Jastrzębski +13 more
TL;DR: LBBAP provides remarkably low and stable pacing thresholds and was associated with improved clinical and echocardiographic outcomes and provides an alternative option for CRT.
Journal ArticleDOI
Left bundle branch pacing: A comprehensive review.
Shunmuga Sundaram Ponnusamy,Vanita Arora,Narayanan Namboodiri,Vivek Kumar,Aditya Kapoor,Pugazhendhi Vijayaraman +5 more
TL;DR: Left bundle branch pacing (LBBP) has been suggested as an effective alternative to overcome the limitations of HBP as it provides low and stable pacing threshold, lead stability, and correction of distal conduction system disease.
Journal ArticleDOI
Physiology-based electrocardiographic criteria for left bundle branch capture
Marek Jastrzębski,Grzegorz Kiełbasa,Karol Curila,Paweł Moskal,Agnieszka Bednarek,Marek Rajzer,Pugazhendhi Vijayaraman +6 more
TL;DR: In this paper, the authors established electrocardiographic (ECG) criteria for LBB capture and showed equivalency of LV activation times on ECG during native and paced LBB conduction.
Journal ArticleDOI
Left bundle branch area pacing outcomes: the multicentre European MELOS study
Marek Jastrzębski,Grzegorz Kiełbasa,Oscar Cano,Karol Curila,Luuk I.B. Heckman,Jan De Pooter,Milan Chovanec,Leonard M. Rademakers,Wim Huybrechts,Domenico Grieco,Zachary I. Whinnett,Stefan A.J. Timmer,Arif Elvan,Petr Stros,Paweł Moskal,Haran Burri,Francesco Zanon,Kevin Vernooy +17 more
TL;DR: Permanent transseptal left bundle branch area pacing is feasible as a primary pacing technique for both bradyarrhythmia and heart failure indications but success rate in heart failure patients and safety need to be improved.
Journal ArticleDOI
Initial Experience, Safety, and Feasibility of Left Bundle Branch Area Pacing: A Multicenter Prospective Study.
Santosh K. Padala,Vivak Master,Maria Terricabras,Andrea Chiocchini,Aatish Garg,Jordana Kron,Richard K. Shepard,Gautham Kalahasty,Zahara Azizi,Bernice Tsang,Yaariv Khaykin,Alfredo Pantano,Jayanthi N. Koneru,Kenneth A. Ellenbogen,Atul Verma +14 more
TL;DR: LBBA pacing is safe, feasible, and a reliable alternative to His bundle pacing for providing physiological pacing and Randomized controlled studies are needed to confirm the safety, feasibility, and clinical outcomes of LBBAP.
References
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Journal ArticleDOI
A Novel Pacing Strategy With Low and Stable Output: Pacing the Left Bundle Branch Immediately Beyond the Conduction Block
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.
Journal ArticleDOI
A beginner's guide to permanent left bundle branch pacing.
Journal ArticleDOI
Permanent His bundle pacing: Recommendations from a Multicenter His Bundle Pacing Collaborative Working Group for standardization of definitions, implant measurements, and follow-up
Pugazhendhi Vijayaraman,Gopi Dandamudi,Francesco Zanon,Parikshit S. Sharma,Roderick Tung,Weijian Huang,Jayanthi N. Koneru,Hiroshi Tada,Kenneth A. Ellenbogen,Daniel L. Lustgarten +9 more
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.
Journal ArticleDOI
Prospective evaluation of feasibility and electrophysiologic and echocardiographic characteristics of left bundle branch area pacing
Pugazhendhi Vijayaraman,Faiz A. Subzposh,Angela Naperkowski,Ragesh Panikkath,Kaitlyn John,Vernon Mascarenhas,Terry D. Bauch,Weijian Huang +7 more
TL;DR: HBP and LBBAP may significantly increase the overall success of physiologic pacing and be feasible in a high percentage of patients with low thresholds during acute follow-up.
Journal ArticleDOI
Permanent left bundle branch area pacing for atrioventricular block: Feasibility, safety, and acute effect
Xiaofei Li,Hui Li,Wentao Ma,Xiaohui Ning,Erpeng Liang,Kunjing Pang,Yan Yao,Wei Hua,Shu Zhang,Xiaohan Fan +9 more
TL;DR: Preliminary results indicate that LBBAP holds promise as an attractive physiological pacing strategy for AVB, and cardiac function and left ventricular synchronization by 2-dimensional echocardiographic strain imaging at the 3-month follow-up slightly improved compared with that at baseline.