Pacing parameters and success rates of permanent His-bundle pacing in patients with narrow QRS: a single-centre experience

Su, Lan; Wu, Shengjie; Wang, Songjie; Wang, Zhengxian; Xiao, Fangyi; Shan, Peiren; Zhou, Hao; Huang, Zhouqing; Xu, Lei; Huang, Weijian

doi:10.1093/europace/euy281

Cited by 58 publications

(61 citation statements)

References 13 publications

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“…Lead parameters were then analyzed in both unipolar and bipolar configurations. Dual‐lead technique reported previously 15,16 was also used to improve the success rate of LBBP lead implantation in challenging implants.…”

Section: Methodsmentioning

confidence: 99%

“…Lead parameters were then analyzed in both unipolar and bipolar configurations. Dual-lead technique reported previously 15,16 was also used to improve the success rate of LBBP lead implantation in challenging implants. In the patients with a recorded intrinsic LBB potential, COI of the LBB was considered present if greater than 25% LBB potential to ventricle (PV) segment elevation or PV depression compared with baseline isoelectric segment appeared after lead fixation.…”

Section: Patientsmentioning

confidence: 99%

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Electrophysiological characteristics and clinical values of left bundle branch current of injury in left bundle branch pacing

Cai

et al. 2020

Cardiovasc electrophysiol

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Background Left bundle branch pacing (LBBP) is emerging as a novel option for physiological ventricular pacing. The impact of current of injury (COI) at left bundle branch (LBB) has not been previously evaluated. Methods Consecutive patients with QRS duration less than 120 milliseconds referred for LBBP in whom LBB potentials were recorded were included from August 2018 to March 2019. We recorded LBB COI during LBBP and assessed its impact on the pacing parameters and complications during implantation and at short term follow‐up. Results A total of 115 patients with an identifiable LBB potential at implant were included. LBB COI was confirmed in 77 (67.0%) of these patients. Three types of LBB COI were observed. LBB was captured in all patients at a pacing threshold less than 1.5 V/0.5 ms in COI(+) patients, while present in only 29 patients without an LBB COI(−) (100% vs 76.3%; P < .001). There was no significant difference between COI(+) and COI(−) patients in LBB bundle capture threshold (0.64 ± 0.24 vs 0.74 ± 0.26 V/0.5 ms). Selective LBBP was more common in COI(+) group than COI(−) group (54.5% vs 0%; P < .001). Pacing parameters were stable and no lead perforation or dislodgements were observed during follow‐up. Conclusions LBB COI is commonly observed during LBBP in cases with an identifiable LBB potential and can be associated with a low LBB capture threshold and demonstrable selective capture of the LBB acutely and during follow‐up. A COI does not preclude safe and stable LBBP pacing.

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Section: Methodsmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

Electrophysiological characteristics and clinical values of left bundle branch current of injury in left bundle branch pacing

Cai

et al. 2020

Cardiovasc electrophysiol

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“…His bundle pacing (HBP) is a feasible and effective modality for ventricular activation and has been reported in many studies . However, the capture threshold is often higher in this region compared to right ventricular pacing sites while R‐wave amplitudes are generally lower .…”

Section: Introductionmentioning

confidence: 99%

Electrophysiological parameters and anatomical evaluation of left bundle branch pacing in an in vivo canine model

Chen

Jin

et al. 2019

Cardiovasc electrophysiol

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Introduction: Left bundle branch pacing (LBBP), a form of conduction system pacing in addition to His bundle pacing (HBP), can potentially maintain left ventricular electrical synchrony with better sensing and a low and stable capture threshold. Methods:We performed both HBP and LBBP using a canine model (n = 3; male;weight 30-40 kg). The electrocardiogram (ECG), intracardiac electrogram characteristics, and pacing parameters were compared between HBP and LBBP. The hearts were isolated and stained by Lugol's iodine (5%) to assess the relative locations of the leads in relation to the conduction system. Results:The average potential to ventricle interval was longer with HBP compared to LBBP (26.67 ± 3.06 ms vs 12.67 ± 1.15 ms; P = .002). There were also notable differences in the pacing parameters between HBP and LBBP: R-wave amplitude (2.67 ± 0.42 mV vs 11.33 ± 3.06 mV; P = .008), pacing impedance (423.3 ± 40.4 vs 660.0 ± 45.8; P = .003), and threshold (2.30 ± 0.66 V/0.4ms vs 0.67 ± 0.15 V/0.4 ms; P = .014). The paced morphology of ECG was similar to the intrinsic with HBP while a right bundle branch block pattern was noted with LBBP. The anatomical evaluation revealed the location of the leads and the average lead depth was significantly more with LBBP as compared to HBP (12.33 ± 1.53 mm vs1.83 ± 0.29 mm; P < .0001). Furthermore, with LBBP, the tip of the lead helix was noted to be around the LBB. Conclusion:This in vivo canine model study confirms the significant differences between HBP and LBBP. Furthermore, this model provides a precise anatomic evaluation of the location and the depth of the leads in relation to the conduction system. K E Y W O R D S anatomical evaluation, canine model, conduction system pacing, electrocardiogram, His bundle pacing, left branch bundle pacing SUPPORTING INFORMATION Additional supporting information may be found online in the Supporting Information section. How to cite this article: Chen X, Jin Q, Li B, et al. Electrophysiological parameters and anatomical evaluation of left bundle branch pacing in an in vivo canine model.

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“…A second lead (Model 3830, Medtronic) was added and moved towards the ventricular side using the proximal His bundle pacing (HBP) lead as a marker to achieve peri-left bundle branch pacing (LBBP). 1,2 As the lead was advanced deep into the ventricular septum, LBB potential was recorded regularly before each ventricular electrograms ( Figure 1A). Unipolar tip pacing resulted in a paced QRS of right bundle branch block (RBBB) morphology and achieved selective LBBP at the threshold of 0.3 V/0.5 ms and local myocardial capture at the output of 0.5 V/0.5 ms with similar stimulus to peak left ventricular (LV) activation time of 84 ms ( Figure 1C and D).…”

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Peri-left bundle branch pacing in a patient with right ventricular pacing-induced cardiomyopathy and atrioventricular infra-Hisian block

Wang

et al. 2019

EP Europace

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Case report A 74-years-old man who received a dual-chamber pacemaker with right ventricular (RV) septal pacing due to advanced atrioventricular (AV) block 6 years ago developed a RV pacing-induced cardiomyopathy with left ventricular ejection fraction (LVEF) of 34% and a left ventricular end-diastolic diameter (LVEDd) of 62 mm. We decided to upgrade the RV pacing to a conduction system pacing. Electrograms obtained from the pacing lead at the His-bundle revealed AV nodal disease with progressive prolongation of A-H interval with dropped His and complete infra-Hisian AV block with dissociation of His and ventricular electrograms (Figure 1A). Pacing at this site Published on behalf of the European Society of Cardiology. All rights reserved.

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Pacing parameters and success rates of permanent His-bundle pacing in patients with narrow QRS: a single-centre experience

Cited by 58 publications

References 13 publications

Electrophysiological characteristics and clinical values of left bundle branch current of injury in left bundle branch pacing

Electrophysiological characteristics and clinical values of left bundle branch current of injury in left bundle branch pacing

Electrophysiological parameters and anatomical evaluation of left bundle branch pacing in an in vivo canine model

Peri-left bundle branch pacing in a patient with right ventricular pacing-induced cardiomyopathy and atrioventricular infra-Hisian block

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