April 30, 2026Heart Rhythm1 citationsOpen Access
View Full PaperRadiofrequency current–facilitated implantation of left bundle branch pacing lead for cardiac resynchronization therapy
Key Result
Radiofrequency-facilitated left bundle branch pacing lead implantation was successful in 35 of 37 challenging cases, with good lead performance and stability over a mean follow-up of 236 days.
Key Points
- The aim is to evaluate the outcomes of using radiofrequency for lead implantation in difficult cases of left bundle branch pacing.
- Analyzed data from 37 RF-facilitated lead implantations in 36 patients
- Measured RF power, delivery time, complications, lead stability, and pacing parameters
- Follow-up duration averaged 236 days
- Lead implantation success rate was 94.6%, with only 2 failures
- Average of 2.1 RF applications per implantation, with median power of 27 W
- Good lead performance with follow-up threshold at 0.8 V and absence of severe proarrhythmia in most cases
Study Design
Type
Observational (n=36)
Structured PICO
Does radiofrequency current-facilitated implantation allow successful left bundle branch pacing lead placement in challenging cases?
P
Population
36 patients (average age 71.6 ± 8.8 years), 89% eligible for cardiac resynchronization therapy (CRT), undergoing challenging left bundle branch pacing (LBBP) lead implantation.
I
Intervention
Radiofrequency (RF) current delivered to the lead tip for septal electrosection during left bundle branch pacing (LBBP) lead implantation (median power 27 W, average 2.1 ± 1.7 applications).
O
Outcome
Acute and follow-up outcomes including lead deployment success, RF power and delivery time, complications, lead stability, proarrhythmia, current of injury, and pacing parameters.surrogate
Radiofrequency-facilitated left bundle branch pacing lead implantation is a feasible bailout technique for challenging cases, particularly in patients eligible for cardiac resynchronization therapy.
Abstract
BACKGROUND: Fibrosis within the interventricular septum hinders the implantation of left bundle branch pacing (LBBP) lead, particularly in candidates for cardiac resynchronization therapy (CRT). OBJECTIVE: This study aimed to report the acute and follow-up outcomes of pacing lead implantation using radiofrequency (RF) current delivered to the lead tip for septal electrosection in challenging LBBP cases. METHODS: Data on lead deployment success, RF power and delivery time, complications, lead stability, proarrhythmia, current of injury, and pacing parameters were collected acutely and at the final follow-up. RESULTS: A total of 37 RF-facilitated lead implantations in 36 patients (average age 71.6 ± 8.8 years), most of whom were CRT eligible (89%), were analyzed. On average, 2.1 ± 1.7 RF applications (resulting in 2.6 ± 2.2 seconds of RF) were used per implantation with a median power of 27 W. RF delivery was used in 85.7% of cases to achieve a current of injury drop that could not be obtained with manual lead rotation alone. Lead implantation was successful in all but 2 cases. The mean follow-up duration was 236 ± 165 days. Lead performance, including pacing parameters and lead stability, was good and did not seem to be affected by RF use (follow-up threshold 0.8 ± 0.3 V; sensitivity: 12.0 ± 5.6 mV). 1 patient experienced sustained ventricular tachycardia, and in all other cases, proarrhythmia was absent or self-limited. No other complications were noted. CONCLUSION: RF-facilitated LBBP lead implantation is a feasible technique with potential cautious use as a bailout in selected cases, especially for failed CRT delivery.
Cite This Study
Jastrzębski et al. (Wed,) conducted a observational in Challenging left bundle branch pacing (LBBP) cases, mostly CRT eligible (n=36). Radiofrequency current-facilitated left bundle branch pacing lead implantation was evaluated on Lead deployment success. Radiofrequency-facilitated left bundle branch pacing lead implantation was successful in 35 of 37 challenging cases, with good lead performance and stability over a mean follow-up of 236 days.