Key result
Using an isoelectric interval as an endpoint to guide left bundle branch pacing was feasible, achieving confirmed left bundle branch capture in 92.7% of cases.
Why the study?
The feasibility and safety of a novel left bundle branch pacing procedure using an isoelectric interval as an endpoint for lead implantation had not been evaluated.
Does using an isoelectric interval as an endpoint for lead implantation improve the feasibility and safety of left bundle branch pacing in patients with pacing indications?
Observational (n=41)
No
Does using an isoelectric interval as an endpoint for lead implantation improve the feasibility and safety of left bundle branch pacing in patients with pacing indications?
Using an isoelectric interval as an endpoint for left bundle branch pacing lead implantation is feasible, safe, and achieves a high rate of successful capture.
Isoelectric-guided LBBP feasible in small series; leaves open need for randomized validation versus conventional endpoints.
BACKGROUND: The present study aimed to evaluate the feasibility and safety of the novel left bundle branch pacing (LBBP) procedure that uses isoelectric interval as an endpoint for lead implantation. METHODS: A total of 41 patients with indications for pacing were enrolled. All patients underwent a novel LBBP procedure guided by recording an isoelectric interval as an endpoint for lead implantation. The procedural details and electrophysiological characteristics were then analyzed. RESULTS: A total of 38/41 (92.7%) cases were confirmed of left bundle branch (LBB) capture. An isoelectric interval was observed in 36/41 cases (87.8%). A total of 36/41 (87.8%) cases with LBB potential were observed. The mean unipolar LBBP threshold at the implant was 0.5 ± 0.2 V. The mean sensed amplitude of the R wave and the pacing impedance at the implant were 12.9 ± 5.0 mV and 723.5 ± 117.1 Ω. During the final threshold testing, a transition from non-selective to selective LBBP (S-LBBP) was demonstrated in 26 patients. A transition from non-selective LBBP (NS-LBBP) to left ventricular septal myocardial capture was observed in 12 patients. CONCLUSION: Using an isoelectric interval as an endpoint to guide the LBBP was feasible in a high proportion of captured LBB cases.
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Wu et al. (2022) conducted an observational in Indications for permanent pacemaker implantation (n=41). Left bundle branch pacing guided by isoelectric interval was evaluated on Confirmed left bundle branch capture. Using an isoelectric interval as an endpoint to guide left bundle branch pacing was feasible, achieving confirmed left bundle branch capture in 92.7% of cases.
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