Key result
Left intrahisian block in surface LBBB is linked to superior correction with His bundle pacing.
Why the study?
Does intracardiac delineation of septal conduction improve the characterization of conduction block compared to surface ECG in patients with LBBB pattern?
Observational
Does intracardiac delineation of septal conduction improve the characterization of conduction block compared to surface ECG in patients with LBBB pattern?
Intracardiac mapping reveals that surface ECG criteria for LBBB incompletely predict true complete conduction block, suggesting intracardiac data may refine patient selection for cardiac resynchronization therapy.
May support intracardiac mapping to refine LBBB conduction assessment; leaves open impact on CRT selection pending prospective data.
Heterogeneous septal conduction was observed in patients with surface LBBB pattern, ranging from no discrete block to CCB. When block was present, we observed pathology localized within the left-sided His fibers (left intrahisian block), which was most amenable to corrective His bundle pacing by recruitment of latent Purkinje fibers. ECG criteria for LBBB incompletely predicted CCB, and intracardiac data might be useful in refining patient selection for resynchronization therapy.
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Upadhyay et al. (2019) conducted an observational in Left bundle-branch block (LBBB). Intracardiac mapping and His bundle pacing was evaluated on Septal conduction pattern and response to His bundle pacing. Intracardiac delineation in surface LBBB revealed heterogeneous septal conduction, with left intrahisian block being most amenable to corrective His bundle pacing.
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