Usefulness of delivery catheter on accurate right ventricular septal pacing: Mt FUJI trial

Naruse, Yoshihisa; Sano, Makoto; Kurebayashi, Nobutake; Morikawa, Shuji; Tsurumi, Naoki; Shiozawa, Tomoyuki; Takano, Shintaro; Ogano, Michio; Kimura, Kei; Miyajima, Keisuke; Sugiura, Ryo; Henmi, Ryuta; Muto, Masahiro; Hosoya, Natsuko; Hasebe, Hideyuki; Mizukami, Akira; Iguchi, Keisuke; Atsumi, Akiko; Odagiri, Keiichi; Kiyama, Yumi; Maekawa, Yuichiro; Kato, Yukio; Saito, Hideki; Daichi, Isomura; Ito, Kazuki; Okazaki, Atsushi; Takashima, Yoshinori; Watanabe, Taiji; Kawaguchi, Yoshitaka; Wakabayashi, Yasushi; Takayama, Yoshiaki; Kohei, Sawasaki; Tanabe, Jun; Soushi, Moriya; Go, Ishikawa; Daigo, Takahashi; Nishio, Ryo; Yamaguchi, Kentaro; Taketo, Sonoda; Yatsu, Shoichiro; Shitara, Jun; Wada, Hideki; Ogita, Manabu; Suwa, Satoru; Yumiko, Joko; Takashi, Ogane; Suzuki, Toshikazu; Tomoya, Iwawaki; Inoue, N.; Tuyoshi, Urushida; Masao, Saotome; Hayato, Ohtani; Suwa, Kenichiro; Satoshi, Mogi; Narumi, Takatsune; Sakakibara, Tomoaki; Kaneko, Yutaro

doi:10.1093/europace/euad027

Cited by 11 publications

(17 citation statements)

References 19 publications

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“…The details of the baseline patient characteristics have been previously reported. 7 There were no significant differences in the baseline characteristics between the catheter and stylet groups. In all patients in the catheter group, C315-HIS (Medtronic) was used as the delivery catheter.…”

Section: Baseline Patient Characteristics Pacemaker Implantation Proc...mentioning

confidence: 84%

“…As described previously, 6,7 the RV lead tip positions were classified into three groups based on CT images: (1) the RVS, (2) the anterior/posterior edge of the RVS wall, and (3) the RV free wall.…”

Section: Assessment Of Lead Tip Positionsmentioning

confidence: 99%

“…FUJI trial showed that the delivery catheter system was associated with a higher rate of successful RV lead placement on the septum than a conventional stylet system. 7 The present subanalysis of the Mt. FUJI trial assessed differences between the groups in ECG findings during RV pacing and their association with lead tip positions.…”

Section: Lead Depth Inside the Septummentioning

confidence: 99%

“…FUJI trial was a multicenter, prospective, and randomized trial to investigate the accuracy of RV lead deployment on the RVS between a delivery catheter and a conventional stylet system. 6,7 One of the advantages of the Mt. FUJI trial is that the RV lead tip position was accurately assessed using computed tomography (CT).…”

Section: Introductionmentioning

confidence: 99%

“…The Mt. FUJI trial was a multicenter, prospective, and randomized trial to investigate the accuracy of RV lead deployment on the RVS between a delivery catheter and a conventional stylet system 6,7 . One of the advantages of the Mt.…”

Section: Introductionmentioning

confidence: 99%

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Delivery catheter system carries more physiological right ventricular septal pacing than stylet system

Hasebe,

Naruse,

Sano

et al. 2024

Cardiovasc electrophysiol

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IntroductionThe Mt. FUJI multicenter trial demonstrated that a delivery catheter system had a higher rate of successful right ventricular (RV) lead deployment on the RV septum (RVS) than a conventional stylet system. In this subanalysis of the Mt. FUJI trial, we assessed the differences in electrocardiogram (ECG) parameters during RV pacing between a delivery catheter system and a stylet system and their associations with the lead tip positions.MethodsAmong 70 patients enrolled in the Mt FUJI trial, ECG parameters, RV lead tip positions, and lead depth inside the septum assessed by computed tomography were compared between the catheter group (n = 36) and stylet group (n = 34).ResultsThe paced QRS duration (QRS‐d), corrected paced QT (QTc), and JT interval (JTc) were significantly shorter in the catheter group than in the stylet group (QRS‐d: 130 ± 19 vs. 142 ± 15 ms, p = .004; QTc: 476 ± 25 vs. 514 ± 20 ms, p < .001; JTc: 347 ± 24 vs. 372 ± 17 ms, p < .001). This superiority of the catheter group was maintained in a subgroup analysis of patients with an RV lead tip position at the septum. The lead depth inside the septum was greater in the catheter group than in the stylet group, and there was a significant negative correlation between the paced QRS‐d and the lead depth.ConclusionUsing a delivery catheter system carries more physiological depolarization and repolarization during RVS pacing and deeper screw penetration in the septum in comparison to conventional stylet system. The lead depth could have a more impact on the ECG parameters rather than the type of pacing lead.

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Section: Baseline Patient Characteristics Pacemaker Implantation Proc...mentioning

confidence: 84%

Section: Assessment Of Lead Tip Positionsmentioning

confidence: 99%

Section: Lead Depth Inside the Septummentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Delivery catheter system carries more physiological right ventricular septal pacing than stylet system

Hasebe,

Naruse,

Sano

et al. 2024

Cardiovasc electrophysiol

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Mid‐term outcomes of delivery catheter‐based and stylet‐based right ventricular septal pacing: Follow‐up results from a multicenter, prospective, randomized study

Tsurumi,

Naruse,

Kurebayashi

et al. 2024

Journal of Arrhythmia

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BackgroundThe Mt FUJI study was a multicenter, prospective, randomized, single‐blind, controlled trial comparing delivery catheter‐based and stylet‐based right ventricular (RV) lead placement at the RV septum. This study extended the follow‐up duration to 1 year after implantation.MethodsSeventy patients with pacemaker indications for atrioventricular block were randomly assigned to the delivery catheter and stylet groups. We compared the mid‐term efficacy and safety between the two groups at 1 year after implantation. The primary outcome was the change in the left ventricular ejection fraction (LVEF), and the secondary outcomes were changes in brain natriuretic peptide (BNP) levels, lead parameters, paced QRS duration, and the incidence of adverse events.ResultsAt the 1‐year follow‐up, no significant differences were observed in the changes in the LVEF (+1.0% ± 8.6% vs. +3.1% ± 8.1%, p = .332), BNP levels (+8.0 [−11.1, 26.5] pg/mL vs. −8.7 [−15.3, 13.2] pg/mL, p = .193), or lead performance between the delivery catheter and stylet groups. The QRS duration was significantly shorter in the delivery catheter group than in the stylet group (128 ± 23 ms vs. 146 ± 17 ms, p < .001). All‐cause death, hospitalization for heart failure, new development of atrial fibrillation, and pacing‐induced cardiomyopathy occurred in seven patients in the delivery catheter group and five in the stylet group.ConclusionThe delivery catheter system was similarly useful and safe compared to the stylet system in the mid‐term follow‐up from the Mt FUJI trial. Further long‐term evaluations are warranted.

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Mid-term clinical outcomes of left bundle branch area pacing compared to accurate right ventricular septal pacing

Okubo,

Sakai,

Miyamoto

et al. 2024

J Interv Card Electrophysiol

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Background Although left bundle branch area pacing (LBBAP) reportedly results in fewer adverse outcomes after implantation than conventional stylet-guided right ventricular septal pacing (RVSP), previous studies have not compared LBBAP with accurate RVSP using a delivery catheter. The aim of this study was to compare clinical outcomes between LBBAP and accurate RVSP among patients with atrioventricular block (AVB). Methods This single-center observational study enrolled 160 patients requiring RV pacing due to symptomatic AVB between September 2018 and December 2021. Primary composite outcomes included all-cause death, hospitalization due to heart failure (HF), and upgrading to biventricular pacing. Secondary composite outcomes included any procedural and postprocedural complications. Results Overall, 160 patients were analyzed (LBBAP, n = 81; RVSP, n = 79). No significant differences in baseline characteristics were observed between the two groups. The RV pacing burden at 1 year after implantation was 90.8% ± 20.4% and 86.2% ± 22.6%, respectively (p = 0.21). During a mean follow-up of 840 ± 369 days, the incidence of the primary outcome was significantly lower with LBBAP (4.9%) compared to RVSP (22.8%) (Log-rank p = 0.02). There was no significant difference in the incidence of the secondary outcome between the two groups (3.7% vs. 5.1%, p = 0.65). In the multivariate analysis, baseline QRS duration, RV pacing burden, and LBBAP were independently associated with the primary outcome (baseline QRS duration: hazard ratio [HR], 1.01; 95% confidence interval [CI], 1.00–1.02; p < 0.001; RV pacing burden: HR, 1.01; 95% CI, 1.00–1.02; p < 0.001; LBBAP: HR, 0.45; 95% CI, 0.31–0.64; p < 0.001). Conclusion In patients requiring frequent RV pacing, LBBAP was associated with reduced adverse clinical outcome compared to accurate RVSP using a delivery catheter. Graphical Abstract

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Usefulness of delivery catheter on accurate right ventricular septal pacing: Mt FUJI trial

Cited by 11 publications

References 19 publications

Delivery catheter system carries more physiological right ventricular septal pacing than stylet system

Delivery catheter system carries more physiological right ventricular septal pacing than stylet system

Mid‐term outcomes of delivery catheter‐based and stylet‐based right ventricular septal pacing: Follow‐up results from a multicenter, prospective, randomized study

Mid-term clinical outcomes of left bundle branch area pacing compared to accurate right ventricular septal pacing

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