Electrophysiological and histological comparisons of left bundle branch pacing vs. left ventricular septal pacing in canine self-controlled models

Figures

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  Figure 1. LBBP vs. LVSP: multiplanar visualization of electrode tip locations and paced ECG characteristics. Panel Aa schematically shows the theoretical lead tip positions of LBBAP. Panels Ab1–Ab3 display the post-implant LBBAP lead tip positions visualized via fluoroscopy, 3-D mapping system, and ICE. Panel Ac presents paced ECG features for LBBP and LVSP. A distinct LBB potential is observed during LBBP, and retrograde His potentials are recorded under both pacing modalities. Panels Ba1 and Ba2 illustrate the initial and final screw-in positions of the LBBAP leads across the right-to-left ventricular septum. Panels Bb1 and Bb2 delineate the electrode penetration tract and distal tip position within the left ventricular septum. Panels Bc1 and c2 show histological images illustrating the distance from electrode tips to the left-sided conduction system under both pacing modalities. Notably, the LBBP electrode tip makes direct contact with the left conduction system. Abbreviations: SR, sinus rhythm; LBBAP, left bundle branch area pacing; LBBP, left bundle branch pacing; LVSP, left ventricular septal pacing; LAF, left anterior fascicle; LPF, left posterior fascicle; ICE, intracardiac…