Low septal lead placement in LBBAP was associated with prominent R waves in V1, shorter sV6RWPT versus mid septum, and longer V6-V1 interpeak intervals (46±10 ms, p<0.01).
Observational (n=212)
Does lead implantation site (high, mid, or low septum) affect ECG parameters in patients undergoing left bundle branch area pacing?
Low septal lead placement in left bundle branch area pacing is associated with specific ECG characteristics, such as prominent R waves in V1 and longer V6-V1 interpeak intervals, which must be accounted for when interpreting ECG criteria for capture.
p-value: p=<0.01
BACKGROUND: Physiology-based electrocardiographic (ECG) criteria are used to assess left bundle branch area pacing (LBBAP), but the impact of lead implantation site on ECG parameters remains unclear. METHODS: We analyzed 212 patients who underwent successful LBBAP and classified them into high septum (HS, n = 49), mid septum (MS, n = 119), and low septum (LS, n = 44) groups according to the polarity of leads II and III. ECG parameters, including QRS morphology in lead V1, stimulus-to-R-wave peak times in V6 and V1 (sV6RWPT, sV1RWPT), and the V6-V1 interpeak interval, were compared. The proportions meeting proposed physiology-based ECG criteria for left bundle branch (LBB) capture were also evaluated. RESULTS: The LS group demonstrated the highest prevalence of dominant R waves in V1 (qR: 38.6%, R: 4.5%, p 44 ms, 86%, p < 0.01). CONCLUSIONS: In LBBAP, low septal lead placement was associated with prominent R waves in V1, shorter sV6RWPT versus the MS group, and longer V6-V1 interpeak intervals, highlighting the importance of implantation site when interpreting ECG findings.
Matsumoto et al. (Thu,) conducted a observational in Left bundle branch area pacing (LBBAP) (n=212). Low septum lead placement vs. High septum and mid septum lead placement was evaluated on Meeting V6-V1 interpeak interval criterion (>44 ms) (p=<0.01). Low septal lead placement in LBBAP was associated with prominent R waves in V1, shorter sV6RWPT versus mid septum, and longer V6-V1 interpeak intervals (46±10 ms, p<0.01).