Comparison between his-bundle pacing and left bundle branch pacing in patients with atrioventricular block

Hu, Yiran; Li, Hui; Gu, Min; Hua, Wei; Niu, Hongxia; Zhang, Nixiao; Liu, Xi; Chen, Xuhua; Hou, Chenping; Zhou, Xiaohong; Zhang, Shu

doi:10.1007/s10840-020-00869-w

Cited by 38 publications

(26 citation statements)

References 20 publications

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“…In this regard, the mean procedure time in our study was not as long as that in the previous studies of the HBP procedure, which demonstrates the usefulness and feasibility of mapping for distal HBE without significant time consumption and related complications. 3,13 Interestingly, our study demonstrated that 62% of the patients in the successful HBP group showed an S-HBP that was significantly higher than the 7% in the previous large-scale study. 3 Of note, the S-HBP was more frequently observed (77%) in patients in whom the distal HBE was detected.…”

Section: Discussioncontrasting

confidence: 48%

Permanent His‐bundle pacing using distal His‐bundle electrogram‐guided approach in patients with atrioventricular block

Suga

Kato

Inden

et al. 2021

Pacing Clinical Electrophis

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Background: Permanent His-bundle pacing (HBP) is effective and safe; however, the success rate of HBP is low, especially in patients with infranodal block. This study aimed to assess the efficacy and feasibility of HBP implantation using an electrophysiological guided approach targeting a distal His-bundle electrogram (HBE) in patients with atrioventricular block (AVB).Methods: Thirty-four consecutive patients with AVB (infranodal block in 28 patients) who underwent HBP were enrolled. During implantation, we attempted to target the distal part of the HBE (distal HBE) beyond the block site based on unipolar mapping.The His-capture threshold was evaluated for 1 year after implantation.Results: HBP was achieved in 26 patients and in 21 patients (75%) with infranodal block. Detection of distal HBE was significantly higher in the successful HBP group than in the HBP failure group (65.4% vs. 0%, p = .001). Among 15 patients with intra-Hisian block, 14 patients (93%) successfully achieved HBP with distal HBE detection.During the 1-year follow-up period, an increase in His-capture threshold by ≥1.0 V at 1.0 ms occurred in five (19.2%) of 26 patients. The increased His-capture threshold group exhibited significantly less detection of distal HBE (20% vs. 76.2%; odds ratio 0.078, 95% confidence interval 0.07-0.87, p = .038) and a higher His-capture threshold at implantation (2.0 ± 1.1 V vs. 1.1 ± 0.9 V; odds ratio 1.702, 95% confidence interval 1.025-2.825, p = 0.04) than the non-increased His-capture threshold group. Conclusion:HBP implantation guided by distal HBE approach may be feasible with subsequent stable pacing in patients with intra-Hisian and atrioventricular nodal block.

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Section: Discussioncontrasting

confidence: 48%

Permanent His‐bundle pacing using distal His‐bundle electrogram‐guided approach in patients with atrioventricular block

Suga

Kato

Inden

et al. 2021

Pacing Clinical Electrophis

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“…To resolve several problems of His bundle pacing, such as an increase in the pacing threshold and inability of left bundle capture in patients with complete left bundle branch block, a novel technique has emerged, aimed at pacing the left bundle directly by implanting a pacing lead at a distal site on the ventricular septum toward the LV. [49][50][51][52][53][54][55][56][57][58][59][60][61] Although this method has been shown to be superior to His bundle pacing in reducing the pacing threshold, 59 several concerns have been reported 49,61 : perforation of the ventricular septum, injury to the conduction system, dislodgement of the lead, injury to the coronary artery (septal branch) and thromboembolism. 51,[59][60][61] Furthermore, because the follow-up intervals of the studies 49,50,56 were ≤3 months, the long-term efficacy of left bundle pacing has not been clarified.…”

Section: Role Of Left Bundle Pacingmentioning

confidence: 99%

“…[49][50][51][52][53][54][55][56][57][58][59][60][61] Although this method has been shown to be superior to His bundle pacing in reducing the pacing threshold, 59 several concerns have been reported 49,61 : perforation of the ventricular septum, injury to the conduction system, dislodgement of the lead, injury to the coronary artery (septal branch) and thromboembolism. 51,[59][60][61] Furthermore, because the follow-up intervals of the studies 49,50,56 were ≤3 months, the long-term efficacy of left bundle pacing has not been clarified. Some investigators have assumed that left bundle branch pacing can be an alternative method to CRT; however, the significance of this method is still unknown owing to the lack of evidence from a randomized clinical trial including a large number of heart failure patients.…”

Section: Role Of Left Bundle Pacingmentioning

confidence: 99%

JCS/JHRS 2021 guideline focused update on non‐pharmacotherapy of cardiac arrhythmias

Nogami¹,

Kurita²,

Kusano³

et al. 2022

Journal of Arrhythmia

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“…The success rate of left bundle branch pacing using a delivery catheter has been reported to be 88%. 16 The success rate of RV septal lead placement using a delivery catheter is expected to be as high as that of left bundle branch pacing. Therefore, the prevalence of successful anchoring of the RV lead tip on the RV septum is estimated to be 85% in the delivery catheter group and 50% in the stylet group.…”

Section: Methods and Analysismentioning

confidence: 99%

Comparison of delivery catheter-based and stylet-based right ventricular lead placement at the right ventricular septum under fluoroscopic guidance judged by cardiac CT (Mt. FUJI): a study protocol for the Mt. FUJI randomised controlled trial

et al. 2021

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IntroductionPacing-induced cardiomyopathy occasionally occurs in patients undergoing pacemaker implantation. Although compared with right ventricular (RV) apical pacing, RV septal pacing can attenuate left ventricular dyssynchrony; the success rate of lead placement on the RV septum using the stylet system is low. Additionally, no randomised controlled trial has addressed the issue regarding the accuracy of RV lead placement on the RV septum using the stylet and delivery catheter systems. This study hypothesises that a newly available delivery catheter system can improve the accuracy of RV lead placement on the RV septum.Methods and analysisIn a multicentre, prospective, randomised, single-blind, controlled trial, 70 patients with pacemaker indication owing to atrioventricular block will be randomised to either the delivery catheter or stylet group before the pacemaker implantation procedure. The position of the RV lead tip will be assessed using ECG-gated cardiac CT in all patients within 4 weeks after pacemaker implantation. Lead tip positions are classified into three groups: (1) RV septum, (2) anterior/posterior edge of the RV septal wall and (3) RV free wall. The primary endpoint will be the success rate of RV lead tip placement on the RV septum, which will be evaluated using cardiac CT.Ethics and disseminationThis study will be conducted according to the stipulations of the Helsinki Declaration and the institutional review board of Hamamatsu University School of Medicine. The results of the study will be disseminated at several research conferences and will be published in peer-reviewed journals.Trial registration numberjRCTs042200014; Pre-results.

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Comparison between his-bundle pacing and left bundle branch pacing in patients with atrioventricular block

Cited by 38 publications

References 20 publications

Permanent His‐bundle pacing using distal His‐bundle electrogram‐guided approach in patients with atrioventricular block

Permanent His‐bundle pacing using distal His‐bundle electrogram‐guided approach in patients with atrioventricular block

JCS/JHRS 2021 guideline focused update on non‐pharmacotherapy of cardiac arrhythmias

Comparison of delivery catheter-based and stylet-based right ventricular lead placement at the right ventricular septum under fluoroscopic guidance judged by cardiac CT (Mt. FUJI): a study protocol for the Mt. FUJI randomised controlled trial

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