Key result
Proximal LBBP with a 4.7-F lumenless ICD lead causes ~6% partial atrial coil extension.
Why the study?
Complete accommodation of the integrated bipolar coil of a 4.7-F lumenless defibrillator lead within the RV can be challenging during LBBP, particularly with proximal LBBP where shorter lead-to-HB distance is associated with greater LVEF improvement.
Describes a technique for slack formation during proximal left bundle branch pacing to facilitate complete accommodation of a 4.7-F lumenless defibrillation lead's integrated bipolar coil within the right ventricle.
A 4.7-F lumenless lead (OmniaSecure, Medtronic) enables left bundle branch pacing (LBBP) with a defibrillator lead, but complete accommodation of its integrated bipolar coil within the right ventricle (RV) can be challenging. Partial coil extension into the right atrium occurred in 6.1% of patients in the LEADR LBBAP trial.1 This challenge may be greater with proximal LBBP, an important consideration because a shorter lead-to-His bundle (HB) distance has been associated with greater improvement in left ventricular ejection fraction.
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Okubo et al. (2026) studied Left bundle branch pacing. Slack formation technique during proximal left bundle branch pacing with a 4.7-F lumenless defibrillation lead (OmniaSecure) was evaluated. Proximal left bundle branch pacing with a 4.7-F lumenless defibrillation lead faces challenges accommodating the integrated bipolar coil within the right ventricle (6.1% partial RA extension in prior data).
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