Evidence map›Paper›PMID 40643055›Full record

ArticleJournal of cardiovascular electrophysiology2025

Kinetics and Disappearance of QRS Transition in Patients Undergoing Left Bundle Branch Pacing - A Novel Method for Classifying Microdislodgement.

Márk Gémesi, Balázs Polgár, Zoltán Gingl, István Marczell, Előd János Zsigmond, Letícia Chityil-Papp, Péter Bógyi, Gábor Zoltán Duray

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Article in Journal of cardiovascular electrophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Procedural Management of Atrial Fibrillation in Older Patients.Reviews in cardiovascular medicine · 2026
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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Márk GémesiDepartment of Cardiology, Central Hospital of Northern Pest - Military Hospital, Budapest, Hungary.ORCID 0009-0003-8769-7153
Balázs PolgárDepartment of Cardiology, Central Hospital of Northern Pest - Military Hospital, Budapest, Hungary.
Zoltán GinglDepartment of Cardiology, Central Hospital of Northern Pest - Military Hospital, Budapest, Hungary.
István MarczellDepartment of Cardiology, Central Hospital of Northern Pest - Military Hospital, Budapest, Hungary.
Előd János ZsigmondDepartment of Cardiology, Central Hospital of Northern Pest - Military Hospital, Budapest, Hungary.
Letícia Chityil-PappDepartment of Cardiology, Central Hospital of Northern Pest - Military Hospital, Budapest, Hungary.
Péter BógyiDepartment of Cardiology, Central Hospital of Northern Pest - Military Hospital, Budapest, Hungary.
Gábor Zoltán DurayDepartment of Cardiology, Central Hospital of Northern Pest - Military Hospital, Budapest, Hungary.

Funding

The authors received no specific funding for this work.
6 · The paper itself

Abstract

introductionQRS transition during the threshold test is the gold standard for confirming direct capture of the Conduction System in patients with left bundle branch pacing (LBBP). Still, we have limited data on the kinetics of QRS transition over time. Microdislodgement is a known complication of left bundle branch area pacing (LBBAP); however, its true incidence depends on the thoroughness of follow-up. We aimed to evaluate the kinetics and disappearance of QRS transition in patients undergoing LBBP, assess the diagnostic yield of QRS transition at various time points, and characterize microdislodgement.

methodsThis prospective study included patients who underwent successful LBBP procedures at a tertiary center between January 2022 and February 2024. Based on the kinetics of QRS transition during intraoperative, postoperative, and follow-up threshold tests, microdislodgement was assessed.

resultsLBB capture was confirmed in 118 of 155 LBBAP patients (76.1%), which defined our LBBP population. Intraoperative QRS transition was observed in 86.4%, which decreased significantly postoperatively (47.0%) and at follow-up (33.0%)-in 92.0% of LBBP patients' capture of LBB remained, while microdislodgement occurred only in 5.0% of LBBP cases.

conclusionThis study evaluates QRS transition kinetics in LBBAP patients, showing significant intraoperative detectability in patients with direct capture of LBB that decreases postoperatively and at first follow-up. Our classification of microdislodgement aids in understanding its impact on pacing outcomes.

Indexed as

Action PotentialsBundle-Branch BlockBundle of HisCardiac Pacing, ArtificialElectrocardiographyHeart RateAgedFemaleHumansKineticsMaleMiddle AgedPredictive Value of TestsProspective StudiesTime FactorsTreatment Outcomeleft bundle branch area pacing (LBBAP)left bundle branch pacing (LBBP)left ventricular septal pacing (LVSP)microdislodgementQRS transition

Identifiers

PMID40643055
PMCPMC12420859

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