Initial experience of left bundle branch area pacing using stylet‐driven pacing leads: A multicenter study

Pooter, Jan De; Özpak, Emine; Calle, Simon; Peytchev, P.; Heggermont, Ward; Marchandise, Sébastien; Provenier, Frank; B, François; Anné, Wim; Pollet, Peter; Barbraud, Cynthia; Gillis, Kris; Timmermans, Frank; Heuverswyn, Frédéric Van; Tung, Roderick; Wauters, Audrey; Waroux, Jean‐Benoit le Polain de

doi:10.1111/jce.15558

Cited by 36 publications

(51 citation statements)

References 22 publications

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“…In this study no comparison to other stylet-driven or lumenless lead delivery systems were made. 14 In a smaller study of 50 patients, this same group compared the stylet-driven Biotronik Selectra 3D system with the lumenless Medtronic C315HIS delivery system and found no differences in LBBP success rates (87% for stylet-driven compared with 89% for lumenless), lead parameters, or procedure or fluoroscopy times. 15 To our knowledge, our study is the first to report on the use of the Boston Scientific SSPC system for LBBP.…”

Section: Discussionmentioning

confidence: 97%

Initial experience with stylet‐driven versus lumenless lead delivery systems for left bundle branch area pacing

Braunstein

Kagan

Olshan

et al. 2022

Cardiovasc electrophysiol

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Introduction: Left bundle branch area pacing (LBBP) has emerged as an alternative method for conduction system pacing. While initial experience with delivery systems for stylet-driven and lumenless lead implantation for LBBP has been described, data comparing outcomes of stylet-driven versus lumenless lead implantation for LBBP are limited. In this study, we compare success rates and outcomes of LBBP with stylet-driven versus lumenless lead delivery systems.Methods: Eighty-three consecutive patients (mean age 74.1 ± 11.2 years; 56 [68%] male) undergoing attempted LBBP at a single institution were identified. Cases were grouped by lead delivery systems used: stylet-driven (n = 53) or lumenless (n = 30).Baseline characteristics and procedural findings were recorded and compared between the cohorts. Intermediate term follow-up data on ventricular lead parameters were also compared.Results: Baseline characteristics were similar between groups. Successful LBBP was achieved in 77% of patients, with similar success rates between groups (76% in stylet-driven, 80% in lumenless, p = 0.79), and rates of adjudicated LBB capture and other paced QRS parameters were also similar. Compared with the lumenless group, the stylet-driven group had significantly shorter procedure times (90 ± 4 vs. 112 ± 31 min, p = 0.004) and fluoroscopy times (10 ± 5 vs. 15 ± 6 min, p = 0.003).Ventricular lead parameters at follow-up were similar, and rates of procedural complications and need for lead revision were low in both groups. Conclusion:Delivery systems for stylet-driven and for lumenless leads for LBBP have comparable acute success rates. Long-term follow-up of lead performance following use of the various delivery systems is warranted.

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Section: Discussionmentioning

confidence: 97%

Initial experience with stylet‐driven versus lumenless lead delivery systems for left bundle branch area pacing

Braunstein

Kagan

Olshan

et al. 2022

Cardiovasc electrophysiol

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“…Lumenless leads are more resistant to screw damage than SDLs when repositioning is required, especially for HBP, which targets fibrotic sites. However, SDLs are gaining popularity for LBBAP, 25 as penetration of the interventricular septum may be facilitated by greater backup by the stylet and by stiff delivery sheaths. Most major manufacturers are currently developing tools that will facilitate implantation and probably increase SDL adoption for LBBAP.…”

Section: Discussionmentioning

confidence: 99%

Conduction system pacing in everyday clinical practice: EHRA physician survey

et al. 2022

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With the increasing interest in conduction system pacing (CSP) over the last few years and the inclusion of this treatment modality in the current guidelines, our aim was to provide a snapshot of current practice across Europe. An online questionnaire was sent to physicians participating in the European Heart Rhythm Association research network as well as to national societies and over social media. Data on previous experience with CSP, current indications, preferred tools, unmet needs, and perceptions for the future are reported and discussed.

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“…Pooter and colleagues 19 reported 2% (n = 8) incidence of septal perforation during LBBP with SDLs. Though the incidence was less, severe helix damage occurred in 3 of 8 patients, resulting in lead disuse, and one helix fractured inside the septum and could not be retrieved.…”

Section: Implantation Techniquementioning

confidence: 97%

“…The surface area of septal perforation with LLL is small and appears to close with no demonstrable shunting during postprocedure echocardiography. 16 It is likely that the SDL may result in larger perforated area and may be associated with increased risk for shunts or cameral fistulas 19 , 20 and has not been studied adequately so far.…”

Section: Implantation Techniquementioning

confidence: 99%

“…Apart from septal perforation which require immediate recognition and repositioning, septal hematoma, 30 coronary artery injury, 31 septal coronary artery fistula, 19 and lead dislodgements are the reported complications of LBBP. Though theoretically possible, so far thromboembolic complications have not been reported both with both LLLs and SDLs after LBBP.…”

Section: Follow-upmentioning

confidence: 99%

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