A Continuous Pacing and Recording Technique for Differentiating Left Bundle Branch Pacing From Left Ventricular Septal Pacing: Electrophysiologic Evidence From an Intrapatient-Controlled Study

Shen, Jiabo; Jiang, Longfu; Wu, Hao; Cai, Xiaojie; Zhuo, Shanshan; Pan, Lifang

doi:10.1016/j.cjca.2022.09.008

Cited by 15 publications

(11 citation statements)

References 31 publications

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“…A previous study had found that the change of intracardiac electrocardiogram can guide left bundle branch pacing by continuous pacing and recording technique 4 . Here, we revealed a novel method to improve stable His bundle capture with low threshold and minor HB injury.…”

Section: Discussionmentioning

confidence: 74%

“…A previous study had found that the change of intracardiac electrocardiogram can guide left bundle branch pacing by continuous pacing and recording technique. 4 Here, we revealed a novel method to improve stable His bundle capture with low threshold and minor HB injury. We thought that the mark to reach the His bundle was the change of the duration and the shape of the His potential under continuous recording screwing.…”

Section: Discussionmentioning

confidence: 98%

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His potential injury as the end point of screwing by a continuous recording technique in His bundle pacing: A case report

Zhong,

Jiang

2024

Pacing Clinical Electrophis

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BackgroundHis bundle pacing (HBP) engaged electrical activation of both ventricles by stimulating the His‐Purkinje network, which could avoid marked ventricles dyssynchrony. The lead was given three to five clockwise rotations at the site with the His potential to anchor the interventricular septum. In 2018, the Multicenter His Bundle Pacing Collaborative Working Group recommended that the His bundle capture threshold should be lower than 2.5 V/1 ms in non‐pacing‐dependent patients, and pacing‐dependent patients should have a lower adjacent ventricular capture threshold as self‐backup. Therefore, to avoid safety issues such as loss of capture caused by increased threshold, we believe that more stringent criteria should be adopted in patients with atrioventricular block (AVB). In previous studies, the connection cable needed to be disconnected during the screwing. When the procedure was finished, the performer found that the patients with His bundle injury could obtain a lower threshold than those without His bundle injury. Although no studies of new bundle branch block (BBB) or AVB by the acute His bundle injury was reported. However, It is worrying that the damage of His bundle seems random during the procedure. How to balance avoiding severe injury with a lower capture threshold? At present, we report a case of light His injury and lower His capture threshold under continuous intracardiac electrocardiogram monitoring.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 98%

His potential injury as the end point of screwing by a continuous recording technique in His bundle pacing: A case report

Zhong,

Jiang

2024

Pacing Clinical Electrophis

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“…the activation time of both ventricles) by producing near simultaneous activation of both ventricles, and is technically simpler than LBB pacing. [ 36 , 37 ] However, when compared with LBB pacing, LVSP has been associated with significantly longer left ventricular activation time in V5-V6 and longer paced QRS durations. [ 33 , 38 ] Consequently, this could potentially lead to a decrease in LV synchrony.…”

Section: Currently Accepted Criteria For Left Bundle Branch Area Pacingmentioning

confidence: 99%

The Emerging Role of Left Bundle Branch Area Pacing for Cardiac Resynchronisation Therapy

Diaz,

Duque,

Aristizabal

et al. 2023

Arrhythm Electrophysiol Rev

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Cardiac resynchronisation therapy (CRT) reduces the risk of heart failure-related hospitalisations and all-cause mortality, as well as improving quality of life and functional status in patients with persistent heart failure symptoms despite optimal medical treatment and left bundle branch block. CRT has traditionally been delivered by implanting a lead through the coronary sinus to capture the left ventricular epicardium; however, this approach is associated with significant drawbacks, including a high rate of procedural failure, phrenic nerve stimulation, high pacing thresholds and lead dislodgement. Moreover, a significant proportion of patients fail to derive any significant benefit. Left bundle branch area pacing (LBBAP) has recently emerged as a suitable alternative to traditional CRT. By stimulating the cardiac conduction system physiologically, LBBAP can result in a more homogeneous left ventricular contraction and relaxation, thus having the potential to improve outcomes compared with conventional CRT strategies. In this article, the evidence supporting the use of LBBAP in patients with heart failure is reviewed.

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“…This retrospective observational study enrolled consecutive patients who underwent successful permanent pacemaker implantation. LBBP uses John Jiang's connecting cable (Xinwell Medical Technology Co., Ltd., Ningbo, Zhejiang, China) for the continuous pacing and recording technique, and the procedure has been described by us elsewhere (7)(8)(9)(10). The study protocol was approved by the Ethics Committee of the Hwa Mei Hospital, Ningbo, China.…”

Section: Patient Population and Definition Of Lbb Capturementioning

confidence: 99%

High-pass filter settings and the role and mechanism of discrete ventricular electrograms in left bundle branch pacing

Shen

Jiang

et al. 2023

Front. Cardiovasc. Med.

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ObjectiveThe characteristics of discrete intracardiac electrogram (EGM) in selective left bundle branch (SLBB) pacing (SLBBP) have not been described in detail previously. This study aimed to examine the effect of different high-pass filter (HPF) settings on discrete local ventricular components in an intracardiac EGM and to analyze its possible mechanisms.MethodsThis study included 144 patients with indications of permanent cardiac pacing. EGMs were collected at four different HPF settings (30, 60, 100, and 200 Hz) with a low-pass filter at 500 Hz, and their possible mechanisms were analyzed.ResultsLBBP was successfully achieved in 91.0% (131/144) of patients. SLBBP was achieved in 123 patients. The occurrence rates of discrete local ventricular EGM were 16.7, 33.3, 72.9, and 85.4% for HPF settings of 30, 60, 100, and 200 Hz, respectively. The analysis of discrete EGM detection showed significant differences between the different HPF settings. By using the discrete local ventricular component and isoelectric interval as the SLBB capture golden standard, the results of EGMs revealed that the 30 Hz HPF has a sensitivity of 19% and specificity of 100%. The 60 Hz HPF had a sensitivity of 39% and a specificity of 100%. The 100 Hz HPF had a sensitivity of 85% and a specificity of 100%. The 200 Hz HPF had a sensitivity of 100% and specificity of 100%.ConclusionAn optimal HPF setting of 200 Hz is recommended for discrete local ventricular EGM detection. A discrete local ventricular EGM should exhibit an isoelectric interval. A steep deflection and high-frequency ventricular EGM morphology nearly identify an intrinsic EGM morphology.

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A Continuous Pacing and Recording Technique for Differentiating Left Bundle Branch Pacing From Left Ventricular Septal Pacing: Electrophysiologic Evidence From an Intrapatient-Controlled Study

Cited by 15 publications

References 31 publications

His potential injury as the end point of screwing by a continuous recording technique in His bundle pacing: A case report

His potential injury as the end point of screwing by a continuous recording technique in His bundle pacing: A case report

The Emerging Role of Left Bundle Branch Area Pacing for Cardiac Resynchronisation Therapy

High-pass filter settings and the role and mechanism of discrete ventricular electrograms in left bundle branch pacing

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