Why the study?
Direct visual anatomical evaluation of lead locations in the interventricular septum and histopathological examination around the lead had not been conducted in humans receiving left bundle branch area pacing.
What are the anatomical and histopathological characteristics of left bundle branch area pacing leads in the human heart?
What are the anatomical and histopathological characteristics of left bundle branch area pacing leads in the human heart?
This first-in-human anatomical and histological evaluation of LBBAP in explanted hearts confirms that leads match fluoroscopic locations and induce localized fibrosis without compromising pacing thresholds.
As an emerging pacing technique, left bundle branch area pacing (LBBAP) has served as a physiological pacing modality that overcomes the limitations of His bundle pacing (HBP) or right ventricular pacing. Three patients with terminal heart failure who were waiting for heart transplantation and met the indications of pacemaker implantations received LBBAP. Symptoms were relieved and stabilized and eventually received heart transplantation. Diseased hearts from the recipients were dissected post-transplantation, and the direct visual of pacing lead locations in the interventricular septum were evaluated, and the histopathological examination around the lead was conducted for the first time in human. As a result, we found that the locations of LBBAP leads were matched with fluoroscopic views during the procedure and Masson's staining showed extensive fibrosis occur around the lead but did not result in high thresholds.
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Zhang et al. (2022) studied this question.
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