Evaluation of the Criteria to Distinguish Left Bundle Branch Pacing From Left Ventricular Septal Pacing

Wu, Shengjie; Chen, Xueying; Wang, Songjie; Xu, Lei; Xiao, Fangyi; Huang, Zhouqing; Zheng, Rujie; Jiang, Limeng; Vijayaraman, Pugazhendhi; Sharma, Parikshit S.; Su, Lan; Huang, Weijian

doi:10.1016/j.jacep.2021.02.018

Cited by 152 publications

(227 citation statements)

References 20 publications

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“…A paced QRS morphology of RBBB (either complete or incomplete) was reported as a necessary (although not sufficient) condition for LBB capture. 7 In our patients, paced QRS had QS morphology in V1 without a clear r wave; thus, this morphological criterion should already exclude LBB capture in both cases.…”

Section: Discussionmentioning

confidence: 54%

Deep septal pacing to upgrade patients with pacing-induced cardiomyopathy

Marco

Faga

Mercé

et al. 2022

HeartRhythm Case Reports

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionmentioning

confidence: 54%

Deep septal pacing to upgrade patients with pacing-induced cardiomyopathy

Marco

Faga

Mercé

et al. 2022

HeartRhythm Case Reports

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“…The lead was then advanced deep into the septum in order to achieve left conduction system capture. LBBP was confirmed ( 19 ) and differentiated from left ventricular septal pacing (LVSP) by the criteria published previously ( 20 ).…”

Section: Methodsmentioning

confidence: 99%

Feasibility and Outcomes of Upgrading to Left Bundle Branch Pacing in Patients With Pacing-Induced Cardiomyopathy and Infranodal Atrioventricular Block

Yue

et al. 2021

Front. Cardiovasc. Med.

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His bundle pacing (HBP) can reverse left ventricular (LV) remodeling in patients with right ventricular (RV) pacing-induced cardimyopathy (PICM) but may be unable to correct infranodal atrioventricular block (AVB). Left bundle branch pacing (LBBP) results in rapid LV activation and may be able to reliably pace beyond the site of AVB. Our study was conducted to assess the feasibility, safety, and outcomes of permanent LBBP in infranodal AVB and PICM patients. Patients with infranodal AVB and PICM who underwent LBBP for cardiac resynchronization therapy (CRT) were included. Clinical evaluation and echocardiographic and electrocardiographic assessments were recorded at baseline and follow-up. Permanent LBBP upgrade was successful in 19 of 20 patients with a median follow-up duration of 12 months. QRS duration (QRSd) increased from 139.3 ± 28.0 ms at baseline to 176.2 ± 21.4 ms (P < 0.001) with right ventricular pacing (RVP) and was shortened to 120.9 ± 15.2 ms after LBBP (P < 0.001). The mean LBBP threshold was 0.7 ± 0.3 V at 0.4 ms at implant and remained stable during follow-up. The left ventricular ejection fraction (LVEF) increased from 36.3% ± 6.5% to 51.9% ± 13.0% (P < 0.001) with left ventricular end-systolic volume (LVESV) reduced from 180.1 ± 43.5 to 136.8 ± 36.7 ml (P < 0.001) during last follow-up. LBBP paced beyond the site of block, which results in a low pacing threshold with a high success rate in infranodal AVB patients. LBBP improved LV function with stable parameters over the 12 months, making it a reasonable alternative to cardiac resynchronization pacing via a coronary sinus lead in infranodal AVB and PICM patients.

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“…Chen et al reported two complications in 612 patients ( 24 ) and Su et al reported two cases of lead dislodgement in 632 patients ( 10 ), which are similar to the incidence in our study. Since Huang et al ( 16 ) published and standardized the LBBP maneuver and criteria ( 18 ), complications like lead dislodgement have been rarely reported in an experienced center.…”

Section: Discussionmentioning

confidence: 99%

“…During the procedure, the duration from the pacing signal to the peak of R wave (on V4-V6 lead) is measured as pacing to left ventricular activation time (p-LVAT), It reflects the activation time of the lateral wall of the left ventricle. An eligible site of left bundle capture was confirmed if selective LBBP was demonstrated by ECG, if p-LVAT shortened abruptly >10 ms through increasing pacing output, or if p-LVAT stayed shortest and stable at the site ( 17 , 18 ).…”

Section: Methodsmentioning

confidence: 99%

Feasibility and Safety of Left Bundle Branch Pacing for Advance Aged Patients: A Multicenter Comparative Study

Ren

Cai

Wang

et al. 2021

Front. Cardiovasc. Med.

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Background: Left bundle branch pacing (LBBP) has been shown to be a safe and effective means to achieve physiological pacing. However, elderly patients have increased risks from invasive procedures and the risk of LBBP in elderly patients is not known. We aimed to investigate the safety and efficacy of LBBP in elderly patients >80 years of age.Methods: From December 2017 to June 2019, 346 consecutive patients with symptomatic bradycardia, 184 patients under 80 years of age and 162 over 80 years, were included and underwent LBBP. The safety and prognosis of LBBP were comparatively evaluated by measured pacing parameters, periprocedural complications, and follow-up clinical events.Results: Compared with the younger, the elderly group had worse baseline cardiac and renal function. LBBP was achieved successfully in both groups with comparable fluoroscopic time and paced QRS duration (110.0 [102.0, 118.0] ms for the young vs. 110.0 [100.0, 120.0] ms for the elderly, P = 0.874). Through a follow-up of 20.0 ± 6.1 months, pacing parameters were stable while higher threshold and impedance were observed in the elderly group. In the evaluation of safety, overall procedure-related complication rates were comparable (4.4 vs. 3.8%, young vs. elderly). For prognosis, similar rates of major adverse cardiocerebrovascular events (7.1 vs. 11.9%, young vs. elderly) were observed.Conclusions: Compared to younger patients, LBBP could achieve physiological pacing in patients over 80 with comparable midterm safety and prognosis. Long-term safety and benefits of LBBP, however, necessitate further evaluation.

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Evaluation of the Criteria to Distinguish Left Bundle Branch Pacing From Left Ventricular Septal Pacing

Cited by 152 publications

References 20 publications

Deep septal pacing to upgrade patients with pacing-induced cardiomyopathy

Deep septal pacing to upgrade patients with pacing-induced cardiomyopathy

Feasibility and Outcomes of Upgrading to Left Bundle Branch Pacing in Patients With Pacing-Induced Cardiomyopathy and Infranodal Atrioventricular Block

Feasibility and Safety of Left Bundle Branch Pacing for Advance Aged Patients: A Multicenter Comparative Study

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