Which Is More Likely to Achieve Cardiac Synchronization: Left Bundle Branch Pacing or Left Ventricular Septal Pacing?

Zhu, Kailun; Chang, Dong; Li, Qiang

doi:10.3389/fcvm.2022.845312

Cited by 4 publications

(12 citation statements)

References 23 publications

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“…20 The values in this study were larger by 48% for LVEDV, larger by 75% for RVEDV, and larger by 19% for the RVEDV:LVEDV ratio. Evaluating ventricular volumes using speckle tracking methods in third trimester low-risk fetuses, Zhu et al reported notably smaller ventricular volumes than this cohort (mean RVEDV = 1.9 mL, LVEDV = 1.9 mL) at a similar gestational age, 21 however a similar technique by DeVore et al estimated the fiftieth percentile LVEDV at 2.5 mL for 34 weeks gestation. 18 The geometric assumptions used in the Simpson's method are challenging for LV volume and even more so with the RV due to its unique shape.…”

Section: Discussionmentioning

confidence: 60%

“…Measurement of ventricular volumes by fetal echocardiography are mostly estimated from a 2D LV and RV area using Simpson's method of discs or speckle tracking derived Simpson's. 18,20,21 This method utilizes similar geometric assumptions to that of Kording et al and may limit comparison to this cohort. Three and four-dimensional techniques, spatio-temporal image correlation and virtual organ computer aided analysis have also been used to establish fetal ventricular volumes, however, clinical utility of the techniques are limited due to artifacts, acoustic windows, and the need for offline postprocessing.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13]16,17 Conversely, the fetal cardiac MRI volumes measured here were larger than those reported by echocardiography by as much as 48% or more. [18][19][20][21] It is speculated that this may be attributable to the single plane measurements and geometric assumptions used in echocardiography calculations. There is limited published cardiac MRI data for volumes; however, our data appears to agree with prior MRI work when considering differences in imaging techniques and study populations.…”

Section: Discussionmentioning

confidence: 99%

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Reference Values for Fetal Cardiac Dimensions, Volumes, Ventricular Function and Left Ventricular Longitudinal Strain Using Doppler Ultrasound Gated Cardiac Magnetic Resonance Imaging in Healthy Third Trimester Fetuses

Minocha,

Englund,

Friesen

et al. 2023

Magnetic Resonance Imaging

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BackgroundRecent advances in hardware and software permit the use of cardiac MRI of late gestation fetuses, however there is a paucity of MRI‐based reference values.PurposeTo provide initial data on fetal cardiac MRI‐derived cardiac dimensions, volumes, ventricular function, and left ventricular longitudinal strain in healthy developing fetuses >30 weeks gestational age.Study TypeProspective.PopulationTwenty‐five third trimester (34 ± 1 weeks, range of 32–37 weeks gestation) women with healthy developing fetuses.Field Strength/SequenceStudies were performed at 1.5 T and 3 T. Cardiac synchronization was achieved with a Doppler ultrasound device. The protocol included T2 single shot turbo spin echo stacks for fetal weight and ultrasound probe positioning, and multiplanar multi‐slice cine balanced steady state free precession gradient echo sequences.AssessmentPrimary analyses were performed by a single observer. Weight indexed right ventricular (RV) and left ventricular (LV) volumes and function were calculated from short axis (SAX) stacks. Cardiac dimensions were calculated from the four‐chamber and SAX stacks. Single plane LV longitudinal strain was calculated from the four‐chamber stack. Interobserver variability was assessed in 10 participants. Cardiac MRI values were compared against available published normative fetal echocardiogram data using z‐scores.Statistical TestsMean and SDs were calculated for baseline maternal/fetal demographics, cardiac dimensions, volumes, ventricular function, and left ventricular longitudinal strain. Bland–Altman and intraclass correlation coefficient analysis was performed to test interobserver variability.ResultsThe mean gestational age was 34 ± 1.4 weeks. The mean RV and LV end diastolic volumes were 3.1 ± 0.6 mL/kg and 2.4 ± 0.5 mL/kg respectively. The mean RV cardiac output was 198 ± 49 mL/min/kg while the mean LV cardiac output was 173 ± 43 mL/min/kg.Data ConclusionThis paper reports initial reference values obtained by cardiac MRI in healthy developing third trimester fetuses. MRI generally resulted in slightly larger indexed values (by z‐score) compared to reports in literature using fetal echocardiography.Evidence level1Technical EfficacyStage 2

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Reference Values for Fetal Cardiac Dimensions, Volumes, Ventricular Function and Left Ventricular Longitudinal Strain Using Doppler Ultrasound Gated Cardiac Magnetic Resonance Imaging in Healthy Third Trimester Fetuses

Minocha,

Englund,

Friesen

et al. 2023

Magnetic Resonance Imaging

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“…LVSP is typically defined as when LBB capture criteria are not met, but a deep septal position may be visualized with contrast and there is a significant reduction in the QRSd (or QRS≤130 ms). (Zhu et al, 2022).…”

Section: Types Of Capturementioning

confidence: 99%

Conduction system pacing in pediatric and congenital heart disease

et al. 2023

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Conduction system pacing (CSP) has evolved rapidly to become the pacing method of choice for many adults with structurally normal hearts. Studies in this population have repeatedly demonstrated superior hemodynamics and outcomes compared to conventional pacing with the recruitment of the native conduction system. Children and patients with congenital heart disease (CHD) are also likely to benefit from CSP but were excluded from original trials. However, very recent studies have begun to demonstrate the feasibility and efficacy of CSP in these patients, with growing evidence that some outcomes may be superior in comparison to conventional pacing techniques. Concerns regarding the technical challenges and long-term lead parameters of His Bundle Pacing (HBP) have been overcome to many extents with the development of Left Bundle Branch Area Pacing (LBBAP), and both techniques are likely to play an important role in pediatric and CHD pacing in the future. This review aims to assimilate the latest developments in CSP and its application in children and CHD patients.

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“…In theory, LBBP rapidly conducts electrical excitation through the intrinsic His-Purkinje system, accelerating the process of LV lateral wall depolarization while comparatively delaying the RV excitation, resulting in electrical dyssynchrony between the left and right ventricles (12,13). LVSP, unlike LBBP, only captures the LV septal myocardium, and the electrical excitation in the interventricular septum is transversely conducted at the same time, so that the LV delayed excitation partially overlaps with the RV delayed excitation, resulting in a more balanced but non-physiological synchronization of the interventricular electrical excitation (2,41).…”

Section: Lbbp Vs Lvspmentioning

confidence: 99%

Criteria for differentiating left bundle branch pacing and left ventricular septal pacing: A systematic review

Zhu

Liu

et al. 2022

Front. Cardiovasc. Med.

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BackgroundAs a novel physiological pacing technique, left bundle branch pacing (LBBP) can preserve the left ventricular (LV) electrical and mechanical synchronization by directly capturing left bundle branch (LBB). Approximately 60–90% of LBBP were confirmed to have captured LBB during implantation, implying that up to one-third of LBBP is actually left ventricular septal pacing (LVSP). LBB capture is critical for distinguishing LBBP from LVSP.Methods and resultsA total of 15 articles were included in the analysis by searching PubMed, EMBASE, Web of Science, and the Cochrane Library database till August 2022. Comparisons of paced QRS duration between LVSP and LBBP have not been uniformly concluded, but the stimulus artifact to LV activation time in lead V5 or V6 (Stim-LVAT) was shorter in LBBP than LVSP in all studies. Stim-LVAT was used to determine LBB capture with a sensitivity of 76–95.2% and specificity of 78.8–100%, which varied across patient populations.ConclusionThe output-dependent QRS transition from non-selective LBBP to selective LBBP or LVSP is direct evidence of LBB capture. LBB potential combined with short Stim-LVAT can predict LBB capture better. Personalized criteria rather than a fixed value of Stim-LVAT are necessary to confirm LBB capture in different populations, especially in patients with LBB block or heart failure.

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Which Is More Likely to Achieve Cardiac Synchronization: Left Bundle Branch Pacing or Left Ventricular Septal Pacing?

Cited by 4 publications

References 23 publications

Reference Values for Fetal Cardiac Dimensions, Volumes, Ventricular Function and Left Ventricular Longitudinal Strain Using Doppler Ultrasound Gated Cardiac Magnetic Resonance Imaging in Healthy Third Trimester Fetuses

Reference Values for Fetal Cardiac Dimensions, Volumes, Ventricular Function and Left Ventricular Longitudinal Strain Using Doppler Ultrasound Gated Cardiac Magnetic Resonance Imaging in Healthy Third Trimester Fetuses

Conduction system pacing in pediatric and congenital heart disease

Criteria for differentiating left bundle branch pacing and left ventricular septal pacing: A systematic review

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