Feasibility and safety of zero‐fluoroscopy left bundle branch pacing: An initial experience

Abstract

Introduction: Left bundle branch pacing (LBBP) has emerged in recent years as a new pacing modality, providing patients with a narrower paced QRS than conventional pacing and stable pacing parameters. At the same time, there is a growing concern about the use of fluoroscopy in pacemaker implantations, given its harmful effects on both patients and operators. However, there are no prior experiences of zero-fluoroscopy in LBBP procedure. Methods:We conducted an observational prospective study recruiting consecutive patients that underwent zero-fluoroscopy LBBP pacemaker implantation. A 6-month follow-up visit was programmed for every patient. The main goal of our study was to assess the efficacy, feasibility, and safety of the procedure.Results: From January 2021 to February 2022, we included 10 patients, 8 males. The average age was 63 ± 4 years. The procedure was successful in all patients. We observed a significant reduction in paced QRS width compared with basal QRS width (149 ± 31.9 vs. 116 ± 15.6 ms, p = .02). All device parameters remained stable at 6-month follow-up: no significant differences in mean impedance (700.5 ± 136.4 vs.

Case Report: Fluoroless implantation of left branch bundle pacing in a pregnant patient

“…Zero-fluoro procedures should be preferred for special patients such as pregnant women ( 2 ). A study of fluoroscopy-free LBBP showed that all device parameters remained stable during follow-up; however, lead slack was suboptimal (too tight or too loose) in some cases ( 3 ). This could increase the risk of long-term complications such as lead dislodgement, septum perforation, or an increased capture threshold.…”