Journal articles: 'Left Bundle Branch Area Pacing'

1

Hasumi, Eriko, and Katsuhito Fujiu. "Tripartite Left Bundle Branch Area Pacing." International Heart Journal 62, no. 1 (January 30, 2021): 1–3. http://dx.doi.org/10.1536/ihj.20-771.

Full text

APA, Harvard, Vancouver, ISO, and other styles

2

Michalik, Jędrzej, Roman Moroz, Marek Szołkiewicz, Alicja Dąbrowska-Kugacka, and Ludmiła Daniłowicz-Szymanowicz. "Left Bundle Branch Area Pacing to Overcome Coronary Sinus Anatomy-Related Technical Problems Encountered during Implantation of Biventricular CRT—A Case Report." Journal of Clinical Medicine 13, no. 11 (June 4, 2024): 3307. http://dx.doi.org/10.3390/jcm13113307.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

The results of clinical trials show that up to one-third of patients who are eligible for cardiac resynchronization therapy (CRT) do not benefit from biventricular pacing. The reasons vary, including technical problems related to left ventricle pacing lead placement in the appropriate branch of the coronary sinus. Herein, we present a case report of a patient with heart failure with reduced ejection fraction and left bundle branch block, in whom a poor coronary sinus bed made implantation of classic biventricular CRT impossible, but in whom, alternatively, rescue-performed left bundle branch area pacing allowed effective electrical and mechanical cardiac resynchronization. The report confirms that left bundle branch area pacing may be a rational alternative in such cases.

3

Perepeka, Eugene O., Borys B. Kravchuk, Oksana M. Paratsii, Liliana M. Hrubyak, Volodymyr L. Leonchuk, and Maryna M. Sychyk. "Transventricular Left Bundle Branch Pacing." Ukrainian Journal of Cardiovascular Surgery 30, no. 1 (46) (March 23, 2022): 89–93. http://dx.doi.org/10.30702/ujcvs/22.30(01)/pk016-8993.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Background. Implementation of conduction system permanent pacing methods in patients with cardiac bradyarrhythmias allows to maintain the physiological sequence of excitation and contraction of the ventricles and to avoid the development of heart failure due to electrical and mechanical dyssynchrony in patients with high rates of ventricular pacing. Case description. A 61-year-old female patient was examined and treated at the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine from January 25 to January 27, 2022 at the department of surgical treatment of complex cardiac arrhythmias with a diagnosis of proximal complete atrioventricular block. A two-chamber pacemaker (Vitatron Q50A2) with a ventricular lead to stimulate the His bundle region (Medtronic 3830, 69 cm) was implanted to the patient with a special delivery system (C315HIS). At an X-ray operating room, 12 ECG leads from the electrophysiological station LabSystem Pro (Bard, USA) were connected to the patient to analyze the criteria for capturing the conduction system on stimulation during ventricular lead placement, and a diagnostic quadripolar electrode was inserted into the right ventricle to record the potential of the His bundle as an X-ray reference point. During placement of the ventricular lead in the area of the His bundle due to high pacing thresholds the decision was made to implement an alternative method of conduction system pacing – left bundle branch pacing through the interventricular septum. After gradual passage of the electrode through the septum, capture of the conduction system of the heart was achieved, although no clear potential of the left bundle was registered. The interval from stimulus to peak R wave in lead V6 was 68 ms, and the interval from stimulus to peak R wave in lead V1 was 110 ms. The difference between intervals was 42 ms, which indicated the criteria of nonselective capture of the left bundle branch, with stimulation thresholds below 1 V at a pulse length of 0.5 ms. In the postoperative period, the patient was evaluated for global longitudinal deformity of the left ventricle on constant ventricular stimulation, which was carried out according to standard methods using speckle-tracking echocardiography; no signs of dyssynchrony were found. Also, the location of the endocardial electrode in the middle segments of the interventricular septum on the right ventricular side was visualized and confirmed by performing B-mode transthoracic echocardiography with subcostal access. Conclusions. Left bundle branch pacing, like His bundle pacing, maintains electrical and mechanical synchrony of the left ventricle at lower pacing thresholds, greater amplitude of the sensitivity signal and lower risks of lead dislocation.

4

Garg, Aatish, Vivak Master, Kenneth A. Ellenbogen, and Santosh K. Padala. "Painful Left Bundle Branch Block Syndrome Successfully Treated With Left Bundle Branch Area Pacing." JACC: Case Reports 2, no. 4 (April 2020): 568–71. http://dx.doi.org/10.1016/j.jaccas.2019.11.081.

Full text

APA, Harvard, Vancouver, ISO, and other styles

5

PESTREA, Catalin, Alexandra GHERGHINA, Irina PINTILIE, and Florin ORTAN. "Learning Curve for Left Bundle Branch Area Pacing – the Experience of a Romanian Academic Center." Romanian Journal of Cardiology 31, no. 2 (July 2, 2021): 327–34. http://dx.doi.org/10.47803/rjc.2021.31.2.327.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Introduction: There is an increasing interest in the past decade for more physiological pacing strategies due to detrimental long-term right ventricular pacing. His bundle pacing is the most physiological one, but it has some drawbacks, mainly an increased pacing threshold. Left bundle branch area pacing (LBBAP) emerged in the recent years as the next step in conduction system pacing. We present our initial experience and learning curve with this latter procedure. Material and methods: During January 2019 and February 2021, 20 patients with pacing indications that failed initial permanent His bundle pacing underwent successful LBBAP. Results: The mean age was 65.9 ± 12.7 years. The indications for cardiac pacing were AV block in 14 patients(70%) and cardiac resynchronization therapy in 6 patients (30%). At baseline, normal QRS complex was noted in 9 patients, a left bundle branch block pattern in 10 patients and a right bundle branch block in one patient. A total of 18 dual-chamber and one single chamber pacemakers were implanted and a cardiac resynchronization therapy defibrillator (CRT-D) device. The acute pacing threshold was 0.56±0.2 V at 0.4ms, the sensing threshold was 10.3±3.9 mV and the impedance was 684.9±112.2 Ω. The overall QRS duration decreased after LBBAP from 128.5 ± 27ms to 103.6 ± 17.4ms (p= 0.001). In patients with baseline wide QRS complex there was a highly significant decrease from 148.2 ± 11.6 ms to 104.7 ± 19.4 ms (p<0.001). The fl uoroscopy time, including the time spent for His bundle location, was 13.8 ± 8.5 minutes. The pacing thresholds remained constant after three-months (0.6 ± 0.2 V vs. 0.56 ± 0.2 V at 0.4 ms). We had two intraprocedural septal perforations without any consequences and three micro dislodgements at follow-up with pure left septal capture. Conclusion: Left bundle branch area pacing is a feasible physiological pacing technique with a high success rate and the potential to overcome the limits of permanent His bundle pacing. It can be successfully performed virtually in all types of pacing indications, including cardiac resynchronization therapy as provides a rapid and synchronous activation of the left ventricle.

6

Bakelants, Elise, and Haran Burri. "Troubleshooting Programming of Conduction System Pacing." Arrhythmia & Electrophysiology Review 10, no. 2 (July 13, 2021): 85–90. http://dx.doi.org/10.15420/aer.2021.16.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Conduction system pacing (CSP) comprises His bundle pacing and left bundle branch area pacing and is rapidly gaining widespread adoption. Effective CSP not only depends on successful system implantation but also on proper device programming. Current implantable impulse generators are not specifically designed for CSP. Either single chamber, dual chamber or CRT devices can be used for CSP depending on the underlying heart rhythm (sinus rhythm or permanent atrial arrhythmia) and the aim of pacing. Different programming issues may arise depending on the device configuration. This article aims to provide an update on practical considerations for His bundle and left bundle branch area pacing programming and follow-up.

7

Sidhu, Baldeep S., Justin Gould, Mark K. Elliott, Vishal Mehta, Steven Niederer, and Christopher A. Rinaldi. "Leadless Left Ventricular Endocardial Pacing and Left Bundle Branch Area Pacing for Cardiac Resynchronisation Therapy." Arrhythmia & Electrophysiology Review 10, no. 1 (April 12, 2021): 45–50. http://dx.doi.org/10.15420/aer.2020.46.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Cardiac resynchronisation therapy is an important intervention to reduce mortality and morbidity, but even in carefully selected patients approximately 30% fail to improve. This has led to alternative pacing approaches to improve patient outcomes. Left ventricular (LV) endocardial pacing allows pacing at site-specific locations that enable the operator to avoid myocardial scar and target areas of latest activation. Left bundle branch area pacing (LBBAP) provides a more physiological activation pattern and may allow effective cardiac resynchronisation. This article discusses LV endocardial pacing in detail, including the indications, techniques and outcomes. It discusses LBBAP, its potential benefits over His bundle pacing and procedural outcomes. Finally, it concludes with the future role of endocardial pacing and LBBAP in heart failure patients.

8

Rajakumar, Clement, Angela Naperkowski, Faiz Ali Subzposh, and Pugazhendi Vijayaraman. "CLINICAL OUTCOMES OF LEFT BUNDLE BRANCH AREA PACING COMPARED TO HIS BUNDLE PACING." Journal of the American College of Cardiology 79, no. 9 (March 2022): 40. http://dx.doi.org/10.1016/s0735-1097(22)01031-2.

Full text

APA, Harvard, Vancouver, ISO, and other styles

9

Bertini, Matteo. "Special Issue: “Biophysics, Arrhythmias and Pacing”." Biology 12, no. 4 (April 8, 2023): 569. http://dx.doi.org/10.3390/biology12040569.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Cardiac pacing technologies have been implemented during the last few decades, including leadless pacemakers and pacing of the conduction system, such as His bundle pacing and left bundle branch area pacing [...]

10

Martinov, E., D. Boychev, M. Marinov, V. Konstantinova, V. Gelev, and V. Traykov. "Conduction system pacing using intracardiac echocardiography guidance - a case report." Bulgarian Cardiology 29, no. 4 (December 31, 2023): 89–96. http://dx.doi.org/10.3897/bgcardio.29.e116261.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Conduction system pacing (CSP) is a pacing technique involving the implantation of permanent pacing leads at different sites along the cardiac conduction system and includes His bundle pacing (HBP) and left bundle branch area pacing (LBBAP). Intracardiac echocardiography (ICE) might facilitate the implantation of the permanent pacing lead in the left bundle branch (LBB) area of the interventricular septum. We report a case of an 83-year-old patient presenting with right bundle branch block (RBBB), left anterior fascicular block (LAFB), and dizzy spells during episodes of 2:1 atrioventricular (AV) block who underwent CSP with ICE guidance at our center. Apart from standard ﬂ uoroscopic guidance and monitoring  of  intracardiac signals, ICE was also used to monitor lead advancement in the septum during the implantation. The landing zone and penetration depth of the pacing lead through the RV septum, mid-septum, and LBB area septum were easily visualized with ICE. Selective LBBAP demonstrated by the accepted ECG and electrogram criteria was achieved.  Automated strain rate protocol with speckle tracking was used to demonstrate preserved left ventricular (LV) synchrony following the implantation. The use of ICE to guide LBBAP implantation can be used to monitor lead penetration in the septum, potentially improving the safety and efﬁ cacy of this promising pacing modality.

11

Baroni, Matteo, Alberto Preda, Marisa Varrenti, Sara Vargiu, Marco Carbonaro, Federica Giordano, Lorenzo Gigli, and Patrizio Mazzone. "Left Bundle Branch Area Pacing over His Bundle Pacing: How Far Have We Come?" Journal of Clinical Medicine 12, no. 9 (May 2, 2023): 3251. http://dx.doi.org/10.3390/jcm12093251.

Full text

APA, Harvard, Vancouver, ISO, and other styles

12

Rademakers, L. M. "Left bundle branch area pacing for cardiac resynchronisation therapy." Netherlands Heart Journal 28, no. 1 (September 5, 2019): 52–55. http://dx.doi.org/10.1007/s12471-019-01322-y.

Full text

APA, Harvard, Vancouver, ISO, and other styles

13

Pestrea, Catalin, Alexandra Gherghina, Florin Ortan, Gabriel Cismaru, and Rosu Radu. "Left bundle branch area pacing - restoring the natural order." Medicine 99, no. 32 (August 7, 2020): e21602. http://dx.doi.org/10.1097/md.0000000000021602.

Full text

APA, Harvard, Vancouver, ISO, and other styles

14

Heckman, Luuk I. B., Justin G. L. M. Luermans, Karol Curila, Antonius M. W. Van Stipdonk, Sjoerd Westra, Radovan Smisek, Frits W. Prinzen, and Kevin Vernooy. "Comparing Ventricular Synchrony in Left Bundle Branch and Left Ventricular Septal Pacing in Pacemaker Patients." Journal of Clinical Medicine 10, no. 4 (February 17, 2021): 822. http://dx.doi.org/10.3390/jcm10040822.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Background: Left bundle branch area pacing (LBBAP) has recently been introduced as a novel physiological pacing strategy. Within LBBAP, distinction is made between left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP, no left bundle capture). Objective: To investigate acute electrophysiological effects of LBBP and LVSP as compared to intrinsic ventricular conduction. Methods: Fifty patients with normal cardiac function and pacemaker indication for bradycardia underwent LBBAP. Electrocardiography (ECG) characteristics were evaluated during pacing at various depths within the septum: starting at the right ventricular (RV) side of the septum: the last position with QS morphology, the first position with r’ morphology, LVSP and—in patients where left bundle branch (LBB) capture was achieved—LBBP. From the ECG’s QRS duration and QRS morphology in lead V1, the stimulus- left ventricular activation time left ventricular activation time (LVAT) interval were measured. After conversion of the ECG into vectorcardiogram (VCG) (Kors conversion matrix), QRS area and QRS vector in transverse plane (Azimuth) were determined. Results: QRS area significantly decreased from 82 ± 29 µVs during RV septal pacing (RVSP) to 46 ± 12 µVs during LVSP. In the subgroup where LBB capture was achieved (n = 31), QRS area significantly decreased from 46 ± 17 µVs during LVSP to 38 ± 15 µVs during LBBP, while LVAT was not significantly different between LVSP and LBBP. In patients with normal ventricular activation and narrow QRS, QRS area during LBBP was not significantly different from that during intrinsic activation (37 ± 16 vs. 35 ± 19 µVs, respectively). The Azimuth significantly changed from RVSP (−46 ± 33°) to LVSP (19 ± 16°) and LBBP (−22 ± 14°). The Azimuth during both LVSP and LBBP were not significantly different from normal ventricular activation. QRS area and LVAT correlated moderately (Spearman’s R = 0.58). Conclusions: ECG and VCG indices demonstrate that both LVSP and LBBP improve ventricular dyssynchrony considerably as compared to RVSP, to values close to normal ventricular activation. LBBP seems to result in a small, but significant, improvement in ventricular synchrony as compared to LVSP.

15

Jastrzębski, Marek. "Novelties in cardiac pacing. Left bundle branch pacing, a step-by-step guide." In a good rythm 2, no. 59 (September 30, 2021): 27–41. http://dx.doi.org/10.5604/01.3001.0015.4536.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Left bundle branch pacing (LBBP) technique is a new method for conduction system pacing that is useful for both bradyarrhythmia and heart failure indications. LBBP, while less physiological than His bundle pacing, offers several practical advantages. Namely, lower and stable pacing thresholds, good sensing of the intrinsic ventricular activity and easiness in localizing the pacing target. The LBBP method more often than His bundle pacing results in engagement of the conduction system distal to the area of the block. A step-by-step approach to LBBP was described. Attention was given to the following phases of the procedure: 1) localization of the target area on the septum, 2) the lead rotation technique with an interpretation of the lead responses (drill effect, screwdriver effect, entanglement effect), 3) methods for monitoring the lead depth in the septum to avoid perforation (fixation beats, continuous pace mapping, impedance), and 4) methods to differentiate between LBBP and left ventricular septal pacing.

16

Heckman, Luuk, Pugazhendhi Vijayaraman, Justin Luermans, Antonius M. W. Stipdonk, Floor Salden, Alexander H. Maass, Frits W. Prinzen, and Kevin Vernooy. "Novel bradycardia pacing strategies." Heart 106, no. 24 (October 7, 2020): 1883–89. http://dx.doi.org/10.1136/heartjnl-2020-316849.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

The adverse effects of ventricular dyssynchrony induced by right ventricular (RV) pacing has led to alternative pacing strategies, such as biventricular, His bundle (HBP), LV septal (LVSP) and left bundle branch pacing (LBBP). Given the overlap, LVSP and LBBP are also collectively referred to as left bundle branch area pacing (LBBAP). Although among these alternative pacing sites HBP is theoretically the ideal strategy as it maintains a physiological ventricular activation, its application requires more skills and is associated with the most complications. LBBAP, where the ventricular pacing lead is advanced through the interventricular septum to its left side, creates ventricular activation that is only slightly more dyssynchronous. Preliminary studies have shown that LBBAP is feasible, safe and encounters less limitations than HBP. Further studies are needed to differentiate between LVSP and LBBP with regard to acute functional and long-term clinical outcome.

17

Qian, Zhiyong, Yuanhao Qiu, Yao Wang, Zeyu Jiang, Hongping Wu, Xiaofeng Hou, and Jiangang Zou. "Lead performance and clinical outcomes of patients with permanent His-Purkinje system pacing: a single-centre experience." EP Europace 22, Supplement_2 (December 2020): ii45—ii53. http://dx.doi.org/10.1093/europace/euaa295.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract Aims His-Purkinje system (HPS) pacing, including His bundle (HB) and left bundle branch (LBB) pacing, has emerged as a highlighted topic in recent years. Comparisons in lead performance and clinical outcomes between HB and LBB pacing were seldom reported. We aimed to investigate the mid-long-term lead performance and clinical outcomes of permanent HPS pacing patients in our centre. Methods and results Permanent HB pacing was implemented by placing the pacing lead helix at the HB area. Left bundle branch pacing was achieved by placing the lead helix in the left-side sub-endocardium of the interventricular septum. Pacing parameters, 12-lead ECG, echocardiography, and clinical outcomes were evaluated during follow-up. A total of 64 patients with HB pacing and 185 with LBB pacing were included. Left bundle branch pacing exhibited a slightly longer paced QRS duration than HB pacing (117.7 ± 11.0 vs. 113.7 ± 19.8 ms, P = 0.04). Immediate post-operation, LBB pacing had a significant higher R-wave amplitude (16.5 ± 7.5 vs. 4.3 ± 3.6 mV, P < 0.001) and lower capture threshold (0.5 ± 0.1 vs. 1.2 ± 0.8 V, P < 0.001) compared with HB pacing. During follow-up, an increase in capture threshold of >1.0 V from baseline was found in eight (12.5%) patients in the HB pacing group and none in LBB pacing. Paced QRS morphology changed from Qr to QS in lead V1 in seven patients (3.8%) with LBB pacing. Both HB and LBB pacing preserved cardiac function in patients with left ventricular ejection fraction (LVEF) over 50%. In patients with LVEF <50%, both HB and LBB pacing improved clinical outcomes during follow-up. Conclusion His-Purkinje system pacing produced favourable electrical synchrony and improved cardiac function in patients with heart failure. Left bundle branch pacing showed superior pacing parameters over HB pacing. Lead micro-displacement with changes in paced QRS morphology posts a concern in LBB pacing.

18

Popiołek-Kalisz, Joanna, Marcin Szczasny, Tomasz Chromiński, Piotr Denysiuk, and Piotr Błaszczak. "LEFT BUNDLE BRANCH AREA PACING IN COMPLETE ATRIOVENTRICULAR BLOCK DUE TO LYME CARDITIS." In a good rythm 4, no. 69 (May 31, 2024): 14–17. http://dx.doi.org/10.5604/01.3001.0054.6432.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Lyme disease, also known as Lyme borreliosis, is caused by Borrelia bacteria. In Europe, 0.3–4% of untreated cases end up with cardiovascular complications known as Lyme carditis which are often associated with atrioventricular conduction disorders. We present the case of a 26-year-old male who was diagnosed with a complete atrioventricular block in the course of Lyme carditis. After a full course of antibiotic therapy, the block did not resolve, so the patient was qualified for permanent pacing. In the course of the procedure, the left bundle branch area pacing was achieved with no early or long-term complications. This is the first reported case of a left bundle branch area pacing in the atrioventricular complete block due to Lyme carditis.

19

Mitkowski, Przemysław. "Pacing of conduction system EHRA position paper 2023." In a good rythm 1, no. 66 (May 31, 2023): 21–23. http://dx.doi.org/10.5604/01.3001.0053.7281.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Over the last 65 years of the history of cardiac pacing, clinical goals have changed dramatically. The definition of physiological pacing has also evolved. In recent years, there has been a lot of interest in the possibility of direct pacing the conduction system. Particular hopes are associated with direct pacing of the left bundle branch area as it is easier to obtain in comparison to His bundle pacing, does not require advanced electrophysiological systems, and the electrical parameters of the lead are similar to those obtained during classic right ventricular pacing. This year, the EHRA consensus has been published, which introduces definitions of the pacing of specific levels of the conduction system, discusses in detail the technique of the procedure, and requirements for the team and the centre and also provides criteria for obtaining effective pacing. Presents a proposal for the configuration of the pacemaker sockets and lists the most common complications of the procedure. The current paper presents selected definitions and criteria of obtaining effective pacing of the left bundle branch area.

20

Vinocur, Jeffrey M. "Fortuitous Left Bundle Branch Area Pacing in a Small Child." JACC: Case Reports 3, no. 16 (November 2021): 1730–35. http://dx.doi.org/10.1016/j.jaccas.2021.07.032.

Full text

APA, Harvard, Vancouver, ISO, and other styles

21

De Pooter, Jan, Simon Calle, Laurent Demulier, Frank Timmermans, and Frederic Van Heuverswyn. "Septal Coronary Artery Fistula Following Left Bundle Branch Area Pacing." JACC: Clinical Electrophysiology 6, no. 10 (October 2020): 1337–38. http://dx.doi.org/10.1016/j.jacep.2020.08.038.

Full text

APA, Harvard, Vancouver, ISO, and other styles

22

Geng, Jie, Zhixin Jiang, Shigeng Zhang, Xiujuan Zhou, Yuanyuan Chen, Meng Chen, Chongchong Chen, and Qijun Shan. "Reversible T-wave inversions during left bundle branch area pacing." Kardiologia Polska 80, no. 10 (October 31, 2022): 1002–9. http://dx.doi.org/10.33963/kp.a2022.0167.

Full text

APA, Harvard, Vancouver, ISO, and other styles

23

Catrina, Bianca Iulia, Florina Batar, Ioan Manitiu, Liliana Prodan, Ciprian Tanasescu, and Teodora Filip. "Concepts of Cardiac Dyssynchrony and Dynamic Approach." Diagnostics 14, no. 9 (April 30, 2024): 937. http://dx.doi.org/10.3390/diagnostics14090937.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Cardiac conduction involves electrical activity from one myocyte to another, creating coordinated contractions in each. Disruptions in the conducting system, such as left bundle branch block (LBBB), can result in premature activation of specific regions of the heart, leading to heart failure and increased morbidity and mortality. Structural alterations in T-tubules and the sarcoplasmic reticulum can lead to dyssynchrony, a condition that can be treated by cardiac resynchronization therapy (CRT), which stands as a cornerstone in this pathology. The heterogeneity in patient responses underscored the necessity of improving the diagnostic approach. Vectocardiography, ultra-high-frequency ECG, 3D echocardiography, and electrocardiographic imaging seem to offer advanced precision in identifying optimal candidates for CRT in addition to the classic diagnostic methods. The advent of His bundle pacing and left bundle branch pacing further refined the approach in the treatment of dyssynchrony, offering more physiological pacing modalities that promise enhanced outcomes by maintaining or restoring the natural sequence of ventricular activation. HOT-CRT emerges as a pivotal innovation combining the benefits of CRT with the precision of His bundle or left bundle branch area pacing to optimize cardiac function in a subset of patients where traditional CRT might fall short.

24

Li, Yuqiu, Lirong Yan, Yan Dai, Yu’an Zhou, Qi Sun, Ruohan Chen, Jinxuan Lin, et al. "Feasibility and efficacy of left bundle branch area pacing in patients indicated for cardiac resynchronization therapy." EP Europace 22, Supplement_2 (December 2020): ii54—ii60. http://dx.doi.org/10.1093/europace/euaa271.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract Aims The present study was to evaluate the feasibility and clinical outcomes of left bundle branch area pacing (LBBAP) in cardiac resynchronization therapy (CRT)-indicated patients. Methods and results LBBAP was performed via transventricular septal approach in 25 patients as a rescue strategy in 5 patients with failed left ventricular (LV) lead placement and as a primary strategy in the remaining 20 patients. Pacing parameters, procedural characteristics, electrocardiographic, and echocardiographic data were assessed at implantation and follow-up. Of 25 enrolled CRT-indicated patients, 14 had left bundle branch block (LBBB, 56.0%), 3 right bundle branch block (RBBB, 12.0%), 4 intraventricular conduction delay (IVCD, 16.0%), and 4 ventricular pacing dependence (16.0%). The QRS duration (QRSd) was significantly shortened by LBBAP (intrinsic 163.6 ± 29.4 ms vs. LBBAP 123.0 ± 10.8 ms, P < 0.001). During the mean follow-up of 9.1 months, New York Heart Association functional class was improved to 1.4 ± 0.6 from baseline 2.6 ± 0.6 (P < 0.001), left ventricular ejection fraction (LVEF) increased to 46.9 ± 10.2% from baseline 35.2 ± 7.0% (P < 0.001), and LV end-diastolic dimensions (LVEDD) decreased to 56.8 ± 9.7 mm from baseline 64.1 ± 9.9 mm (P < 0.001). There was a significant improvement (34.1 ± 7.4% vs. 50.0 ± 12.2%, P < 0.001) in LVEF in patients with LBBB. Conclusion The present study demonstrates the clinical feasibility of LBBAP in CRT-indicated patients. Left bundle branch area pacing generated narrow QRSd and led to reversal remodelling of LV with improvement in cardiac function. LBBAP may be an alternative to CRT in patients with failure of LV lead placement and a first-line option in selected patients such as those with LBBB and heart failure.

25

Yuan, Zhongyu, Liting Cheng, and Yongquan Wu. "Meta-Analysis Comparing Safety and Efficacy of Left Bundle Branch Area Pacing Versus His Bundle Pacing." American Journal of Cardiology 164 (February 2022): 64–72. http://dx.doi.org/10.1016/j.amjcard.2021.10.025.

Full text

APA, Harvard, Vancouver, ISO, and other styles

26

Haeberlin, Andreas, Siro Canello, Andreas Kummer, Jens Seiler, Samuel H. Baldinger, Antonio Madaffari, Gregor Thalmann, et al. "Conduction System Pacing Today and Tomorrow." Journal of Clinical Medicine 11, no. 24 (December 7, 2022): 7258. http://dx.doi.org/10.3390/jcm11247258.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Conduction system pacing (CSP) encompassing His bundle (HBP) and left bundle branch area pacing (LBBAP) is gaining increasing attention in the electrophysiology community. These relatively novel physiological pacing modalities have the potential to outperform conventional pacing approaches with respect to clinical endpoints, although data are currently still limited. While HBP represents the most physiological form of cardiac stimulation, success rates, bundle branch correction, and electrical lead performance over time remain a concern. LBBAP systems may overcome these limitations. In this review article, we provide a comprehensive overview of the current evidence, implantation technique, device programming, and follow-up considerations concerning CSP systems. Moreover, we discuss ongoing technical developments and future perspectives of CSP.

27

Pestrea, Catalin, Marcela Rusu, Roxana Enache, Ecaterina Cicala, Radu Gavrilescu, Adrian Vaduva, Florin Ortan, Corneliu Iorgulescu, and Radu Vatasescu. "Feasibility of Conduction System Pacing in Patients with Baseline Bundle Branch Block—A Single-Center Mid-Term Follow-Up Study." Journal of Clinical Medicine 13, no. 2 (January 14, 2024): 454. http://dx.doi.org/10.3390/jcm13020454.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Background: The primary prerequisite for a successful conduction system pacing (CSP) procedure is the integrity of the conduction system, which may be impaired if a baseline bundle branch block (BBB) is present. This study aimed to evaluate the feasibility and mid-term performance of permanent CSP in patients with baseline BBB and to compare the results between left bundle branch block (LBBB) and right bundle branch block (RBBB) patterns. Material and methods: A total of 101 patients with typical BBB and an attempt at CSP were retrospectively reviewed. Procedural characteristics, pacing, sensing parameters, and complications at baseline and after a mid-term follow-up were analyzed. Results: The global procedural success for CSP was 93%. His bundle pacing (HBP) had a significantly lower success rate than left bundle branch area pacing (LBBAP) (50.5% vs. 86%). The paced QRS duration was significantly narrower with HBP. The pacing and sensing thresholds were significantly better with LBBAP. Procedural complications occurred only in the LBBAP group (two acute perforations in the LV cavity and one acute chest pain during lead fixation) without long-term sequelae. The HBP and the LBBAP procedural success rates were higher in the RBBB versus the LBBB group (62.5% vs. 44.9% and 100% vs. 81.5%, respectively). Baseline QRS duration, atrial volumes, and right ventricular diameters were significantly associated with HBP procedural failure. The follow-up pacing and sensing thresholds were similar to the baseline values for all pacing methods and BBB morphology. Only one device-related complication leading to pacing interruption was recorded. Conclusion: In patients with bundle branch blocks, CSP is a feasible procedure associated with a high success rate, stable pacing and sensing parameters, and low complication rates over a mid-term follow-up.

28

Rijks, J., L. Heckman, R. Meiburg, A. M. W. Van Stipdonk, S. Westra, R. Cornelussen, S. Ghosh, et al. "Electrophysiologic effects of left bundle branch area pacing: comparing left ventricular septal pacing and left bundle branch pacing." Europace 25, Supplement_1 (May 24, 2023). http://dx.doi.org/10.1093/europace/euad122.395.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Medtronic Background Left bundle branch area pacing(LBBAP) has been introduced as a more physiological pacing alternative to anti-bradycardia pacing and as an alternative to biventricular pacing in cardiac resynchronization therapy (CRT). LBBAP is the common denominator of left ventricular septal pacing(LVSP) and left bundle branch pacing(LBBP). In LVSP, there is only capture of the myocardium on the left side of the interventricular septum, whereas in LBBP there is additional capture of the left bundle branch(LBB) and subsequent Purkinje fibers. Purpose To investigate the electrophysiological differences between LBBP and LVSP. Methods Patients with a permanent pacemaker indication due to bradycardia or heart failure according to current guidelines were included and underwent LBBAP implantation. At baseline and during implantation, electrical activation parameters were recorded pacing at different sites (Right ventricle, LVSP and LBBP), using the standard 12-lead ECG and the ECG BELT. Electrophysiologic measures included: QRS duration, QRSarea calculated from the vectorcardiogram after conversion from the ECG using the Kors matrix, and standard deviation of activation time(SDAT) measured through the ECG BELT. Both QRS area and SDAT are known markers of ventricular dyssynchrony. Results 28 patients (17 male), with an age of 67±7 yrs underwent LBBAP. 21(75%) had a pacing indication for bradycardia with a baseline narrow QRS and 7(25%) for heart failure with a baseline LBBB. In 17 patients (61%) LBB capture was achieved. The remaining patients were treated with LVSP. In patients with baseline narrow QRS, both LVSP and LBBP showed a significant increase in QRS duration(p<0.001, p<0.001 resp.), without a significant difference in QRS duration between LVSP and LBBP(fig. 1 A). There was no significant difference in SDAT between LVSP and LBBP compared to baseline narrow QRS, and a significant SDAT reduction in patients with underlying LBBB (p=0.005, p<0.001 resp.) Furthermore, there was no significant SDAT difference between LVSP and LBBP(fig. 1 B). LVSP showed a small but significant increase in QRSarea compared to baseline narrow QRS (p=0.011) where LBBP showed no difference compared to baseline narrow QRS. Compared to baseline LBBB both LVSP and LBBP showed a significant QRSarea reduction (p=0.003, p<0.001 resp.). Moreover, there was a small but significant reduction in QRSarea when LBBP was achieved over LVSP(p=0.044) (fig. 1 C). Conclusion LVSP and LBBP showed a similar effect on ventricular synchrony in terms of SDAT, with levels of synchrony comparable to normal physiologic activation. Left bundle branch capture resulted in a small, but significant improvement in QRSarea over LVSP. Fig. 1 Relative changes in QRS duration(A), SDAT (B) and QRS area (C) compared to baseline narrow QRS (bradypacing) and baseline heart failure with LBBB. *p<0.05 compared to baseline, **p<0.05 for bradypacing and heart failure with LBBB combined.

29

Li, Jinghao, He Jiang, Jian Cui, Yi Zhang, Meiting Li, Huiming Zhou, and Xiaomei Li. "Comparison of ventricular synchrony in children with left bundle branch area pacing and right ventricular septal pacing." Cardiology in the Young, January 5, 2023, 1–9. http://dx.doi.org/10.1017/s1047951122003675.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract Objective: This study aimed to determine the ideal pacing site in children by comparing the postoperative ventricular synchrony in children with left bundle branch area pacing and those with right ventricular septal pacing. Methods: This retrospective study included children with complete atrioventricular block who underwent permanent pacemaker implantation from March 2019 to August 2021. Patients were grouped according to their ventricular pacing site, the left bundle branch area pacing group and the right ventricular septal pacing group. Two-dimensional speckle tracking echocardiography was used to evaluate the ventricular synchrony. Results: Forty-eight children (median age, 2.7 years; interquartile range, 1.7–4.6 years) were included. The paced QRS duration in the left bundle branch area pacing group was significantly narrower than that in the right ventricular septal pacing group (100.2 ± 9.3 versus 115.4 ± 15.1 ms, p = 0.001). The median follow-up duration was 1.5 years (interquartile range, 1–2 years). At the last follow-up, the average capture threshold of the ventricular electrode in the left bundle branch area pacing group was lower than that in the right ventricular septal pacing group (0.79 ± 0.18 versus 1.20 ± 0.56 V, p = 0.008). The left ventricular intraventricular synchrony parameters in the left bundle branch area pacing group were better than those in the right ventricular septal pacing group (e.g. standard deviation of the time to peak longitudinal strain, 37.4 ± 4.3 versus 46.6 ± 8.2 ms, p = 0.000). The average interventricular mechanical delay time in the left bundle branch area pacing group was significantly shorter than that in the right ventricular septal pacing group (36.4 ± 14.2 versus 52.5 ± 22.7 ms, p = 0.016). Conclusion: Compared with right ventricular septal pacing, left bundle branch area pacing in children produces a narrower QRS duration and better pacing and ventricular synchrony parameters postoperatively.

30

Lin, Jinxuan, Keping Chen, Yan Dai, Qi Sun, Yuqiu Li, Yong Jiang, Yu’an Zhou, et al. "Bilateral Bundle Branch Area Pacing to Achieve Physiological Conduction System Activation." Circulation: Arrhythmia and Electrophysiology 13, no. 8 (August 2020). http://dx.doi.org/10.1161/circep.119.008267.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Background: Left bundle branch pacing (LBBP) is a technique for conduction system pacing, but it often results in right bundle branch block morphology on the ECG. This study was designed to assess simultaneous pacing of the left and right bundle branch areas to achieve more synchronous ventricular activation. Methods: In symptomatic bradycardia patients, the distal electrode of a bipolar pacing lead was placed at the left bundle branch area via a transventricular-septal approach. This was used to pace the left bundle branch area, while the ring electrode was used to pace the right bundle branch area. Bilateral bundle branch area pacing (BBBP) was achieved by stimulating the cathode and anode in various pacing configurations. QRS duration, delayed right ventricular activation time, left ventricular activation time, and interventricular conduction delay were measured. Pacing stability and short-term safety were assessed at 3-month follow-up. Results: BBBP was successfully performed in 22 of 36 patients. Compared with LBBP, BBBP resulted in greater shortening of QRS duration (109.3±7.1 versus 118.4±5.7 ms, P <0.001). LBBP resulted in a paced right bundle branch block configuration, with a delayed right ventricular activation time of 115.0±7.5 ms and interventricular conduction delay of 34.0±8.8 ms. BBBP fully resolved the right bundle branch block morphology in 18 patients. In the remaining 4 patients, BBBP partially corrected the right bundle branch block with delayed right ventricular activation time decreasing from 120.5±4.7 ms during LBBP to 106.1±4.2 ms during BBBP ( P =0.005). Conclusions: LBBP results in a relatively narrow QRS complex but with an interventricular activation delay. BBBP can diminish the delayed right ventricular activation, producing more physiological ventricular activation. Graphic Abstract: A graphic abstract is available for this article.

31

Mehta, Nikhil A., Bilal Saqi, Syed Rafay Ali Sabzwari, Rahul Gupta, Apurva Vyas, Jeffrey Gordon, Sergio Cossu, Talha Nazir, Ronald Freudenberger, and Babak Bozorgnia. "DURABILITY OF LEFT BUNDLE BRANCH AREA PACING." Journal of Cardiovascular Electrophysiology, May 18, 2022. http://dx.doi.org/10.1111/jce.15545.

Full text

APA, Harvard, Vancouver, ISO, and other styles

32

Das, Asit, Suman Chatterjeet Das, and Aniruddha Mandal. "Left bundle branch area pacing: Electrocardiographic features." Journal of Arrhythmia, August 7, 2021. http://dx.doi.org/10.1002/joa3.12610.

Full text

APA, Harvard, Vancouver, ISO, and other styles

33

Burri, Haran. "Complications with left bundle branch area pacing." Heart Rhythm, February 2022. http://dx.doi.org/10.1016/j.hrthm.2022.01.032.

Full text

APA, Harvard, Vancouver, ISO, and other styles

34

Daoud, Emile G., and Gaurang Gandhi. "Left Bundle Branch Area Pacing for All . . . ?" JACC: Clinical Electrophysiology, June 2024. http://dx.doi.org/10.1016/j.jacep.2024.05.019.

Full text

APA, Harvard, Vancouver, ISO, and other styles

35

Briongos-Figuero, Sem, Álvaro Estévez Paniagua, Ana Sánchez Hernández, and Roberto Muñoz-Aguilera. "Redefining QRS transition to confirm left bundle branch capture during left bundle branch area pacing." Frontiers in Cardiovascular Medicine 10 (July 14, 2023). http://dx.doi.org/10.3389/fcvm.2023.1217133.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

BackgroundQRS transition criteria during dynamic manoeuvers are the gold-standard for non-invasive confirmation of left bundle branch (LBB) capture, but they are seen in <50% of LBB area pacing (LBBAP) procedures.ObjectiveWe hypothesized that transition from left ventricular septal pacing (LVSP) to LBB pacing (LBBP), when observed during lead penetration into the deep interventricular septum (IVS) with interrupted pacemapping, can suggest LBB capture.MethodsQRS transition during lead screwing-in was defined as shortening of paced V6-R wave peak time (RWPT) by ≥10 ms from LVSP to non-selective LBBP (ns-LBBP) obtained during mid to deep septal lead progression at the same target area, between two consecutive pacing manoeuvres. ECG-based criteria were used to compared LVSP and ns-LBBP morphologies obtained by interrupted pacemapping.ResultsSixty patients with demonstrated transition from LVSP to ns-LBBP during dynamic manoeuvers were compared to 44 patients with the same transition during lead screwing-in. Average shortening in paced V6-RWPT was similar among study groups (17.3 ± 6.8 ms vs. 18.8 ± 4.9 ms for transition during dynamic manoeuvres and lead screwing-in, respectively; p = 0.719). Paced V6-RWPT and aVL-RWPT, V6-V1 interpeak interval and the recently described LBBP score, were also similar for ns-LBBP morphologies in both groups. LVSP morphologies showed longer V6-RWPT and aVL-RWPT, shorter V6-V1 interpeak interval and lower LBBP score punctuation, without differences among the two QRS transition groups. V6-RWPT < 75 ms or V6-V1 interpeak interval > 44 ms criterion was more frequently achieved in ns-LBBP morphologies obtained during lead screwing-in compared to those obtained during dynamic manoeuvres (70.5% vs. 50%, respectively p = 0.036).ConclusionsDuring LBBAP procedure, QRS transition from LVSP to ns-LBBP can be observed as the lead penetrates deep into the IVS with interrupted pacemapping. Shortening of at least 10 ms in paced V6-RWPT may serve as marker of LBB capture.

36

Saleiro, Carolina, Pedro A. Sousa, Catarina Nogueira, Lídia Mota, Claúdia Almeida, Gisela Bragança, and Francisco Paisana. "His bundle pacing and left bundle branch area pacing: Feasibility and safety." Revista Portuguesa de Cardiologia, March 2023. http://dx.doi.org/10.1016/j.repc.2022.10.013.

Full text

APA, Harvard, Vancouver, ISO, and other styles

37

Jiwani, Sania, Ninad Nadkarni, Vivek Reddy, Amit Noheria, and Seth Sheldon. "Abstract 18911: Ventriculo-Atrial (VA) Interval as a Measure of Proof of Capture of the Left Bundle." Circulation 148, Suppl_1 (November 7, 2023). http://dx.doi.org/10.1161/circ.148.suppl_1.18911.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Introduction: Left bundle branch area pacing (LBBAP) has provided a safe and effective method of capturing the conduction system for physiologic pacing. Given direct capture of the conduction system, we hypothesized that in patients with retrograde conduction, capture of the left bundle would result in shortening of the interval from ventricular activation to atrial activation (VA interval). To our knowledge, proof of shortening of the VA interval has only previously described as a diagnostic method of confirming left bundle capture in one published case report. In our proof-of-concept study we demonstrate VA interval shortening in 3 patients with intact retrograde conduction noted intraoperatively. Hypothesis: Capture of the left bundle will result in shortening of the VA interval and can be used as a method to confirm LBB capture in patients with intact retrograde conduction. Methods: VA interval measurements were made in patients with intact retrograde conduction. VA interval measurements were performed with capture of the RV septum only and with capture of the left bundle branch. Measurements were all made during implantation and occurred either during active lead deployment, or after left bundle branch area pacing results were obtained. If left bundle branch area pacing results were obtained first, then pacing unipolar from the ring was used as a surrogate for RV septal capture and pacing unipolar from the tip was used for left bundle capture.We did not distinguish between selective and non-selective left bundle branch pacing in this study. Results: In all three patients, capture of the left bundle resulted in shortening of the VA interval. Changes in VA interval were noted to be: 208 ms to 186 msec, 239 msec to 189 msec and 245 msec to 191 msec. The image in Figure 1 illustrates shortening of the VA interval. Conclusions: In patients with retrograde VA conduction, VA interval shortening may serve as an additional useful criterion of left bundle branch capture.

38

Yang, Zhen, Jiadong Liang, Ruizhe Chen, Naidong Pang, Nan Zhang, Min Guo, Jia Gao, and Rui Wang. "Clinical outcomes of left bundle branch area pacing: Prognosis and specific applications." Pacing and Clinical Electrophysiology, December 19, 2023. http://dx.doi.org/10.1111/pace.14907.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

AbstractCardiac pacing has become a widely accepted treatment strategy for bradyarrhythmia and heart failure. However, conventional right ventricular pacing (RVP) has been associated with electrical dyssynchrony, which may result in atrial fibrillation and heart failure. To achieve physiological pacing, Deshmukh et al. reported the first case of His bundle pacing (HBP) in 2000. This strategy was reported to have preserved ventricular synchronization by activating the conventional conduction system. Nonetheless, due to the anatomical location of the His bundle (HB), several issues such as high pacing thresholds, lead fixation, and early battery depletion may pose a challenge. Recently, left bundle branch area pacing (LBBAP) has emerged as a novel physiological pacing strategy to achieve conduction system pacing by capturing the left bundle branch through the deep septum. Additionally, several studies have investigated the clinical outcomes of LBBAP. In this paper, we describe the pacing parameters, QRS duration (QRSd), cardiac function, complications, and specific applications of LBBAP in recent years.

39

Dell'Era, Gabriele, Chiara Ghiglieno, Federica De Vecchi, Matteo Santagostino, Lucia Annunziata, Irene Baldassarre, Daniele Giacopelli, and Giuseppe Patti. "Closed loop stimulation in left bundle branch area pacing." Pacing and Clinical Electrophysiology, June 8, 2024. http://dx.doi.org/10.1111/pace.15022.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

AbstractIntroductionClosed Loop Stimulation (CLS) is a rate‐responsive algorithm that adjusts heart rate (HR) based on changes in intracardiac impedance measured from the right ventricle lead. However, the use of CLS in conduction system pacing has not been investigated. In this retrospective study, we aimed to assess whether CLS with left bundle branch area pacing (LBBAP) can generate an appropriate distribution of HR in daily life.Methods and ResultsOur study included 24 patients with CLS pacing and chronotropic incompetence, comparing them with 19 patients receiving DDD pacing, all with LBBAP. Cumulative HR distribution charts were generated using data from a single device interrogation with a minimum follow‐up period of 30 days. In DDD‐CLS mode, there was a higher percentage of atrial pacing compared to DDD mode (median 58% [interquartile range 29%‐83%] vs. 13% [10%‐26%], p = .001), and CLS‐paced beats were present across all frequency bins. The distribution of beats between the groups was similar (p = .643), resulting in comparable mean HR (72 bpm [70‐77] vs. 73 bpm [65‐75], p = .615).ConclusionsIn the context of LBBAP, CLS effectively modulates pacing rates over a wide frequency range. This lead position does not adversely affect the rate‐responsive performance of the algorithm.

40

Estevez Paniagua, A., S. Briongos Figuero, A. Sanchez Hernandez, and R. Munoz Aguilera. "Left bundle branch area pacing: predictors of success." EP Europace 24, Supplement_1 (May 18, 2022). http://dx.doi.org/10.1093/europace/euac053.440.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract Funding Acknowledgements Type of funding sources: None. Background Frequent conventional pacing of the right ventricle can be deleterious. In the last three years, left bundle branch area pacing (LBBAP) has experienced a great development as a tool for the specific conduction system stimulation. Methods Single-center prospective study of consecutive patients with attempted LBBAP for bradycardia or heart failure indications (bailed-out strategy). A 3830-69 lead was implanted using a C-315-His sheath, and we aimed for left bundle branch pacing (LBBP) in all patients. Current criteria to define LBAPP, LBBP (selective or non-selective), and left ventricle septal pacing (LVSP) were used. The goal of our study was to analyze clinical, electrical, and echocardiographic variables that may predict the achievement of LBBP. Results We included 149 patients between Feb/20 and Jan/22. Baseline characteristics and pacing indications are shown in table 1. We had success in 145 patients (97.3%): 78.9% were considered LBBP (44.4% SLBBP), and 21.1% LVSP. Paced QRS was significantly higher in patients with wide basal QRS (120.9 ± 15.2 ms vs 110.7 ± 12.6 ms, p<0.001). Likewise, left ventricular activation time (LVAT) in V5/V6 and aVL was shorter in the group with narrow basal QRS (77.2 ± 10.5 vs 83.3 ± 11.4, p<0.001, and 80.0 ± 14.1 vs 87.6 ± 14.4, p <0.001, respectively), being much more frequent to achieve an LVAT <80 ms in the group with narrow QRS (64.9% vs 42.2%, OR 2.6, p = 0.004). Logically, the variation of the paced QRS compared to baseline was also different in both groups (-25.4 ± 12.5 ms in the wide QRS group and + 16.2 ± 13.8 ms in the narrow QRS group). LBBP was achieved to a greater extent in the narrow QRS group (89.2% vs 67.6%, OR 3.9, p=0.002); the difference between selective and non-selective LBBP based on baseline QRS was not significant. Regarding the clinical variables, the presence of hypertension, diabetes mellitus, heart failure or COPD did not show a significant difference in the achievement of LBBP. In contrast, it was significantly less frequent to achieve LBBP in patients with LV systolic dysfunction of any degree (62.0% vs 83.2%, p=0.02), or chronic ischemic heart disease (61.1% vs 82.1%, p=0.04), with a trend in patients with CKD (67.7% vs 82.6%, p=0.06). Also, the bradycardia pacing indication had a significant influence, with the percentage of LBBP being lower in patients with atrioventricular conduction system disease compared to sick sinus syndrome (72.0% vs 85.1%, p=0.04). On the other hand, there was no significant association between the achievement of LBBP and echocardiographic parameters such as interventricular septum thickness, and left atrial volumen. Conclusions LBBAP as elective ventricular pacing is feasible, with a high success rate, and in most cases, it is possible to capture the conduction system. However, there appear to be factors that a priori may pose a greater challenge in its achievement, highlighting the electrical conduction system and myocardial disease.

41

"Left Bundle Branch Area Pacing in AVB Patients." Case Medical Research, February 22, 2019. http://dx.doi.org/10.31525/ct1-nct03851315.

Full text

APA, Harvard, Vancouver, ISO, and other styles

42

Schricker, Amir A., and Jonathan Salcedo. "Left bundle branch area pacing: “sides” does matter." Journal of Interventional Cardiac Electrophysiology, December 2, 2023. http://dx.doi.org/10.1007/s10840-023-01702-w.

Full text

APA, Harvard, Vancouver, ISO, and other styles

43

Wang, Jian, Qing-Qing Zhang, Jie Lin, Wei Yuan, Li-Chun Wang, and Yu-Cheng Wu. "Treatment strategy for heart failure complicated with complete left bundle branch block and atrial tachycardia: a case report." Journal of Medical Case Reports 18, no. 1 (January 27, 2024). http://dx.doi.org/10.1186/s13256-024-04343-3.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract Background For patients with heart failure combined with complete left bundle branch block, cardiac resynchronization therapy is an important therapeutic method. If these patients also have atrial tachycardia, how to choose a treatment strategy deserves discussion. Case presentation A Chinese woman in her early 70s was admitted due to recurrent episodes of chest distress and asthma for 1 year. Physical and laboratory examinations showed filling of the jugular vein, lung rales, left enlargement of the heart boundary, edema of the lower limbs and elevation of N-terminal pro b-type natriuretic peptide. An electrocardiogram showed atrial tachycardia and a left bundle branch block. An echocardiography revealed enlargement of the left ventricle and left ventricular systolic dysfunction. After obtaining informed consent, the treatment strategy decided upon by the team was to use biventricular cardiac resynchronization therapy treatment and to not intervene for the atrial tachycardia, with left bundle branch area pacing as a backup. Due to twisted and narrow coronary vein branches, traditional biventricular pacing failed, and then, left bundle branch area pacing was attempted successfully. A follow-up echocardiography at 1 year showed improved systolic function. The outcomes for this patient are favorable, but the choice of interventional strategy is worthy of discussion in this case. Conclusion For patients with heart failure combined with left bundle branch block and atrial tachycardia, left bundle branch area pacing can replace traditional biventricular pacing for cardiac resynchronization therapy treatment, and the therapeutic effect is significant. However, multiple factors need to be considered when formulating strategies, including whether there is bundle branch block under sinus rhythm, the success and recurrence rate of atrial tachycardia ablation, the response of cardiac resynchronization therapy, the costs of different strategies, and instrument implantation issues.

44

Vijayaraman, Pugazhendhi, Clement Rajakumar, Angela M. Naperkowski, and Faiz A. Subzposh. "Clinical Outcomes Of Left Bundle Branch Area Pacing Compared To His Bundle Pacing." Journal of Cardiovascular Electrophysiology, April 30, 2022. http://dx.doi.org/10.1111/jce.15516.

Full text

APA, Harvard, Vancouver, ISO, and other styles

45

Jeong, Hyung Ki, and Sung Soo Kim. "A successful case of left bundle branch area pacing using stylet-driven pacing leads with a steerable delivery sheath in patients with structural heart disease." International Journal of Arrhythmia 24, no. 1 (June 2, 2023). http://dx.doi.org/10.1186/s42444-023-00098-y.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract Background Left bundle branch area pacing (LBBAP) has emerged as a novel form of physiological pacing. However, few physicians have used stylet-driven pacing leads with a steerable delivery sheath for left fascicular bundle pacing. Case presentation A 75-year-old man with a history of heart valve surgery and atrial fibrillation arrived at the emergency department complaining of exertional dyspnea and general weakness. Twelve-lead electrocardiography showed atrial fibrillation with regular RR intervals with escape beats of 41 beats per minutes, which suggested complete atrioventricular block. Two-dimensional echocardiography showed global hypokinesia and a huge atrium. Given the impaired left ventricular (LV) function and the deleterious effects of right ventricular apical pacing, conduction system pacing was attempted. Mapping of His bundle and left bundle potential using a steerable delivery sheath was attempted; however, it did not appear prominent. Several attempts to deploy the lead failed because the sheath was malpositioned such that the lead could not move perpendicularly. Reshaping the sheath allowed for an extended reach so that the pacing lead could be positioned inferior to the previously attempted site toward the apex, deep inside the septum, where the distal left septal fascicle was captured rather than the left bundle branch trunk. During the 6-month follow-up period, the patient was free of any symptoms. Capture threshold and sensing value were stable and follow-up echocardiography showed slightly improved LV function. Conclusions Left fascicular bundle pacing may be an alternative strategy when conventional pacing using stylet-driven pacing leads with a steerable delivery sheath fails to capture the left branch bundle in patients with challenging anatomy.

46

Cerantola, Maxime, David S. Frankel, David J. Callans, Pasquale Santangeli, and Robert D. Schaller. "Left Bundle Branch Area Pacing for the treatment of Painful Left Bundle Branch Block Syndrome." HeartRhythm Case Reports, December 2022. http://dx.doi.org/10.1016/j.hrcr.2022.12.003.

Full text

APA, Harvard, Vancouver, ISO, and other styles

47

Estevez Paniagua, A., S. Briongos Figuero, A. Sanchez Hernandez, and R. Munoz Aguilera. "Left bundle branch area pacing: feasible, safe and successful." EP Europace 24, Supplement_1 (May 18, 2022). http://dx.doi.org/10.1093/europace/euac053.435.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract Funding Acknowledgements Type of funding sources: None. Background Frequent conventional pacing of the right ventricle (RVP) can be deleterious. In the last 3 years, pacing of the left bundle branch area (LBBAP) has experienced great development for the specific conduction system stimulation, displacing His bundle pacing. Methods Prospective study of consecutive patients who received LBBAP for bradicardia or heart failure indications (bailed-out strategy). A 3830-69 lead was implanted using a C-315-His sheath, aiming for left bundle branch pacing (LBBP) in all procedures. We used current criteria to define LBAPP, LBBP (selective or non-selective), and left ventricle septal pacing (LVSP). The purpose of our study was to analyze the feasibility of changing from RVP to LBBAP in bradycardia indication, or LBBAP after sinus coronary lead failure, focusing on the safety and success of the technique. Results We enrolled 149 consecutive patients from our hospital who underwent a LBBAP attempt between Feb/20 and Jan/22. Baseline characteristics and pacing indications are shown in table 1. Mean baseline QRS width was 119.3 ± 29.5 ms. 48.3% of patients showed wide (>120 ms) QRS complex. LBBAP was considered successful in 97.3% of the patients: 78.9% was interpreted as LBBP (44.4% considered selective), and 21.1% as LVSP. Regarding the achievement of criteria to define LBBAP, R´ wave in V1 was obtained in 83% of patients, left bundle branch potential (LBBPo) in 44%, with a mean interval time of LLBPo-local ventricular electrogram of 18.1 ± 6.0 ms. The left ventricular activation time (LVAT) in V5/V6 was 80.1 ± 11.3 ms, and in aVL was 83.7 ± 14.7 ms. Mean procedure time was 21.3 ± 18.0 minutes and the fluoroscopy time was 9.9 ± 10.1 minutes. Mean paced QRS was 115.5 ± 14.8 ms, with mean variation from the baseline QRS of + 4.31 ± 24.7 ms. Mean implant parameters were: R wave amplitude 10.9 ± 5.4 mV, impedance 1004.1 ± 233.6 ohms (monopolar), and threshold 0.94 ± 0.65 V (0.4 ms). In the first follow-up (85.2 ± 38.0 days), parameters were similar or better (Table 1). There were only two patients (1.1%) who presented complications related to the technique: one lead dislodgement and one significant threshold increase. When comparing the first 30 cases with the following ones (Table 2), there was a significant difference in the percentage of implant success (90% vs. 99.1%, p = 0.026), in the LVAT-aVL (94.8 ± 13.6 vs. 81.1 ± 13.7 ms, p <0.001) and a marked trend in the LVAT-V5/V6 (83.8 ± 11.8 vs. 79.3 ± 11.1 ms, p = 0.06). A trend towards a shorter duration of paced QRS was found in the initial cases (110.9 ± 11.8 vs. 116.6 ± 15.2, p = 0.07), which could be explained by the lower percentage of SLBPP (23.5% vs. 48%, p = 0.05). Conclusions LBBAP as elective type of ventricular pacing is feasible, with a high success rate, which improves with the learning curve, showing safety and efficacy. The procedure and fluoroscopy times seem acceptable, considering that know-how may help reduce them.

48

Heckman, L. I. B., J. Luermans, B. Weijs, A. M. W. Van Stipdonk, M. Mafi-Rad, F. Prinzen, and K. Vernooy. "Electrical characteristics of deep septal vs. left bundle branch (area) pacing." European Heart Journal 41, Supplement_2 (November 1, 2020). http://dx.doi.org/10.1093/ehjci/ehaa946.0768.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract Background/Introduction Recent studies have described transvenous left bundle branch (LBB) pacing as a new conduction system pacing strategy. However, information on effect of pacing depth within the septum and the additional effect of LBB capture is unknown. Purpose To investigate the relation of electrocardographic characteristics with transseptal LV lead implantation depth and LBB capture. Methods 20 consecutive patients referred for pacemaker implantation were enrolled. The right atrial (RA) lead was positioned according to routine practice. The LV septal pacing lead (Medtronic 3830) was transvenously positioned against the right side of the interventricular septum and advanced in small steps of 1–2mm towards the left side of the septum. At each depth in the septum 12-lead ECG's were recorded during pacing, from which vectorcardiograms (VCG) were calculated. QRS duration and QRS area were measured, the latter being the integral of the QRSarea in X, Y and Z directions. Successful LBB capture was defined as paced right bundle branch block (RBBB) morphology, stable and short stimulus to LV activation time (LVAT; R in V5) and recorded LBB potential. Differences were compared among pacing conditions using repeated measures ANOVA with Bonferroni multiple comparisons procedure applied to pairwise comparisons. Statistical significance was assumed at p<0.05. Results LV septal lead implantation was successful in all patients. Left bundle branch capture was achieved in 10/20 patients (50%). Post-procedural LV pacing threshold, impedance and sensing was 0.7±0.1 V at 0.5 ms pulse width, 658±5 Ω and 13±10 mV, respectively. Compared to intrinsic rhythm, QRS duration was significantly increased by both RV septum (RVS; 124±5 vs. 161±3 ms) and LV septum pacing (LVS; 142±3 ms). QRS area increased significantly during RVS pacing as compared to intrinsic rhythm but decreased when moving from RVS to LVS to values close to intrinsic rhythm (panel A & B). LVS-pacing derived QRS area was significantly lower in patients with LBB capture (36±6 mV*ms) compared to patients without LBB capture (deep septal pacing; 46±12 mV*ms). The reduction in QRS area between RVS and LVS pacing coincided with normalization of the QRS vector in the transverse plane (panel C), which is characterized electrocardiographically by predominantly negative-to-positive inversion of the QRS complex in the precordial leads (V1-V3). Conclusions Compared to RV septal pacing, LV septal pacing restores ventricular electrical synchrony, as determined by QRS area, and normalizes the activation vector in the transverse plane to a level comparable to intrinsic rhythm. Differences in resynchronization between left bundle branch pacing and deep septal pacing are small. LBBAP restores ventricular synchrony Funding Acknowledgement Type of funding source: None

49

Haeberlin, A., J. Seiler, N. Kozhuharov, S. H. Baldinger, H. Servatius, A. Madaffari, G. Thalmann, et al. "Acute procedural outcomes of left bundle branch area pacing compared to His-bundle pacing." Europace 25, Supplement_1 (May 24, 2023). http://dx.doi.org/10.1093/europace/euad122.388.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Abstract:

Abstract Funding Acknowledgements Type of funding sources: None. Background Conduction system pacing (CSP), encompassing left bundle branch area pacing (LBBAP) and His-bundle pacing (HBP), is a novel pacing strategy, which overcomes limitations of conventional right ventricular pacing. Feasibility and early safety of both strategies have been established previously. While HBP is mentioned as an alternative pacing strategy in the latest European and American pacing guidelines, implantation recommendations regarding LBBAP are scarce. Notably, HBP was described to be associated with a significantly higher procedural failure rate compared to LBBAP, making it potentially more contestable. Purpose To compare procedural outcomes after HBP and LBBAP lead implantation. Methods We prospectively assessed 303 consecutive CSP lead implantation attempts at our center from 08/2018 to 11/2022. 81% of all implantations were performed by two high-volume device implanters. Successful conduction system pacing was established according to standard criteria (HBP: QRS morphology, R-wave peak time in V6, programmed stimulation, visibility of a His potential; LBBAP: R-wave peak time in V6, V1-V6-interpeak interval, programmed stimulation or visibility of a left bundle potential) and pacing thresholds (HBP: <4.0V/1.0ms; LBBAP: <2V/0.5ms). Patient selection and the implantation strategy used was at the operator’s discretion. Results Patients with a HBP attempt were younger and had a narrower QRS complex but did not differ with respect to left or right ventricular function and dimension (table showing percentages and median values/interquartile ranges). LBBAP systems were more often implanted in lieu of CRT, whereas HBP systems were more commonly used in case of AV block without heart failure (table). Acute procedural success rate, overall procedure duration and fluoroscopy time were significantly better during LBBAP implantations (all p<0.001). Success rates, sensing values and capture thresholds (@1ms for HBP and @0.5ms for LBBAP) were superior in LBBAP systems, while achieved paced QRS duration was slightly shorter in HBP systems (table, figure 1). Conclusion Success rates and acute procedural outcomes favor implantation of LBBAP compared to HBP systems.

50

Cerbin, Lukasz P., and Lohit Garg. "Lowering the Threshold for Left Bundle Branch Area Pacing." Journal of Cardiovascular Electrophysiology, May 16, 2022. http://dx.doi.org/10.1111/jce.15543.

Full text

APA, Harvard, Vancouver, ISO, and other styles

Journal articles on the topic 'Left Bundle Branch Area Pacing'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles