Left bundle branch area pacing outcomes: the multicentre European MELOS study

Article Cardiac & Cardiovascular Systems

The V6-V1 interpeak interval: a novel criterion for the diagnosis of left bundle branch capture

Marek Jastrzebski et al.

Summary: The V-6-V-1 interpeak interval in ECG during left bundle branch (LBB) area pacing can differentiate between different types of LBB capture, showing potential for clinical use in diagnosing LBB capture.

EUROPACE (2022)

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Article Cardiac & Cardiovascular Systems

Left bundle branch-optimized cardiac resynchronization therapy (LOT-CRT): Results from an international LBBAP collaborative study group

Marek Jastrzebski et al.

Summary: This study assessed the feasibility and outcomes of left bundle branch area pacing (LOT-CRT) combined with coronary venous left ventricular pacing. LOT-CRT achieved greater electrical resynchronization compared to BiV-CRT and LBBAP, making it a feasible and safe alternative when suboptimal electrical resynchronization is obtained with BiV-CRT.

HEART RHYTHM (2022)

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Article Cardiac & Cardiovascular Systems

Influence of Capture Selectivity and Left Intrahisian Block on QRS Characteristics During Left Bundle Branch Pacing

Weiping Sun et al.

Summary: This study examined the QRS and intracardiac characteristics of selective and nonselective left bundle branch pacing using intracardiac mapping. Nonselective left bundle branch pacing resulted in shorter QRS duration and left ventricular activation time compared to selective left bundle branch pacing. Patients with complete conduction block caused by bidirectional left intrahisian block showed a wider-paced morphology of left bundle branch pacing. Achievement of narrow QRS during left bundle branch pacing relies on capture nonselectivity or programmed atrioventricular fusion, rather than intrinsic physiologic synchrony from left bundle branch stimulation.

JACC-CLINICAL ELECTROPHYSIOLOGY (2022)

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Article Cardiac & Cardiovascular Systems

Comparison of Procedure and Fluoroscopy Time Between Left Bundle Branch Area Pacing and Right Ventricular Pacing for Bradycardia: The Learning Curve for the Novel Pacing Strategy

Zhao Wang et al.

Summary: The study shows that the learning curve for Left Bundle Branch Area Pacing (LBBAP) consists of initial, improved, and stable stages, with gradually increasing success rates and decreasing procedure and fluoroscopy time. Compared to Right Ventricular Pacing (RVP), the procedure and fluoroscopy time of LBBAP can approach and potentially reduce to levels close to that of RVP for experienced operators.

FRONTIERS IN CARDIOVASCULAR MEDICINE (2021)

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Article Cardiac & Cardiovascular Systems

Long-Term Safety and Feasibility of Left Bundle Branch Pacing in a Large Single-Center Study

Lan Su et al.

Summary: Left bundle branch pacing (LBBP) showed high success rates and low complication rates in a large population of patients, leading to decreased QRS duration, improved left ventricular function, and reduced severity of tricuspid regurgitation.

CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY (2021)

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Article Cardiac & Cardiovascular Systems

Stimulation and propagation of activation in conduction tissue: Implications for left bundle branch area pacing

Ahmed Niri et al.

Summary: Characterizing wavefront generation and impulse conduction in the left bundle branch has implications for left bundle branch area pacing. The study showed that increasing pacing pulse width can resolve conduction slowing and block in the left bundle branch.

HEART RHYTHM (2021)

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Article Cardiac & Cardiovascular Systems

Fixation beats: A novel marker for reaching the left bundle branch area during deep septal lead implantation

Marek Jastrzebski et al.

Summary: This study found that monitoring fixation beats during deep septal lead deployment in LBB pacing device implantation can improve the safety of the procedure. Fixation beats, characterized by the appearance of qR/rsR' morphology in lead V-1, were observed to indicate whether the desired lead depth had been reached.

HEART RHYTHM (2021)

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Article Cardiac & Cardiovascular Systems

Left bundle branch area pacing using stylet-driven pacing leads with a new delivery sheath: A comparison with lumen-less leads

Jan De Pooter et al.

Summary: This study demonstrates the feasibility of LBBAP using stylet-driven pacing leads, which shows comparable implant success and pacing thresholds to LBBAP with lumen-less pacing leads.

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY (2021)

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Article Cardiac & Cardiovascular Systems

Cardiac troponin release following left bundle branch pacing

Shunumuga S. Ponnusamy et al.

Summary: The study found that LBBP implantation is associated with myocardial injury, but the extent of injury is lower or comparable to other interventional electrophysiology procedures. Patients requiring more than 2 attempts for LBBP are more likely to experience significant elevation of troponin levels.

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY (2021)

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Article Cardiac & Cardiovascular Systems

Physiology-based electrocardiographic criteria for left bundle branch capture

Marek Jastrzebski et al.

Summary: This study aimed to establish ECG criteria for left bundle branch (LBB) capture. The results showed that specific diagnostic criteria based on certain rules had high sensitivity and specificity, which can help determine the status of LBB capture.

HEART RHYTHM (2021)

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Article Medicine, General & Internal

Comparing Ventricular Synchrony in Left Bundle Branch and Left Ventricular Septal Pacing in Pacemaker Patients

Luuk I. B. Heckman et al.

Summary: The study shows that both LVSP and LBBP significantly improve ventricular dyssynchrony compared to RVSP, bringing values close to normal ventricular activation. Patients with left bundle branch capture during LBBP demonstrate the most significant decrease in QRS area.

JOURNAL OF CLINICAL MEDICINE (2021)

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Article Cardiac & Cardiovascular Systems

Contrast-enhanced image-guided lead deployment for left bundle branch pacing

Xi Liu et al.

Summary: Using a visualization technique significantly shortens the procedural and fluoroscopic durations of LBBP implantation, leading to fewer lead repositioning attempts.

HEART RHYTHM (2021)

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Article Cardiac & Cardiovascular Systems

Left Ventricular Myocardial Septal Pacing in Close Proximity to LBB Does Not Prolong the Duration of the Left Ventricular Lateral Wall Depolarization Compared to LBB Pacing

Karol Curila et al.

Summary: This study aimed to compare differences in ventricular depolarization during different ventricular capture types in left bundle branch pacing (LBBp), and found that myocardial left septal pacing (LVSP) resulted in better interventricular synchrony than non-selective LBB pacing (nsLBBp) and selective LBB pacing (sLBBp). LVSP also did not significantly prolong depolarization of the left ventricular lateral wall, making it a promising option for bradycardia patients.

FRONTIERS IN CARDIOVASCULAR MEDICINE (2021)

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Article Cardiac & Cardiovascular Systems

ECG and Pacing Criteria for Differentiating Conduction System Pacing from Myocardial Pacing

Marek Jastrzebski

Summary: It is crucial to differentiate between His-Purkinje system capture and myocardial-only capture during pacing, as they result in different depolarisation patterns in the left ventricle. Various methods such as differential output pacing and programmed stimulation can be used to diagnose HPS capture based on differences in conduction velocities and thresholds.

ARRHYTHMIA & ELECTROPHYSIOLOGY REVIEW (2021)

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Article Cardiac & Cardiovascular Systems

Procedure-Related Complications of Left Bundle Branch Pacing: A Single-Center Experience

Xueying Chen et al.

Summary: In this study involving 612 patients undergoing left bundle branch pacing, the incidence of procedure-related complications such as postoperative septum perforation, postoperative lead dislodgement, intraoperative septum injury, and intraoperative lead fracture was found to be low, with stable pacing parameters and no major complications observed after appropriate treatment.

FRONTIERS IN CARDIOVASCULAR MEDICINE (2021)

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Review Cardiac & Cardiovascular Systems

2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: Developed by the Task Force on cardiac pacing and cardiac resynchronization therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA)

Michael Glikson et al.

EUROPEAN HEART JOURNAL (2021)

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Article Cardiac & Cardiovascular Systems

2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Theresa A. McDonagh et al.

EUROPEAN HEART JOURNAL (2021)

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Article Cardiac & Cardiovascular Systems

Left Bundle Branch Area Pacing for Cardiac Resynchronization Therapy Results From the International LBBAP Collaborative Study Group

Pugazhendhi Vijayaraman et al.

Summary: The study assessed the feasibility and outcomes of left bundle branch area pacing (LBBAP) in patients eligible for cardiac resynchronization therapy (CRT). LBBAP was found to be a safe and effective alternative option for CRT, providing improved clinical and echocardiographic outcomes.

JACC-CLINICAL ELECTROPHYSIOLOGY (2021)

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Article Cardiac & Cardiovascular Systems

Evaluation of the Criteria to Distinguish Left Bundle Branch Pacing From Left Ventricular Septal Pacing

Shengjie Wu et al.

Summary: This study aimed to evaluate the predictive value of electrocardiogram and intracardiac electrogram characteristics for confirmation of left bundle branch capture. The findings suggest that direct LBB capture can be confirmed by recording retrograde His potential and anterograde left conduction system potentials.(ActionEvent - American College of Cardiology Foundation)

JACC-CLINICAL ELECTROPHYSIOLOGY (2021)

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Article Cardiac & Cardiovascular Systems