ArticleHeart rhythm O22025
Multiple electrode leads facilitate left bundle branch area pacing: A concept evaluation study.
Article in Heart rhythm O2, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
Background: Left bundle branch area (LBBA) lead placement relies on single-electrode pacing guided by electrocardiogram markers during transeptal advancement. We hypothesize that multiple electrodes on a lead tip facilitate LBBA pacing. Objective: This study aimed to develop and evaluate a multielectrode lead (MEL) with dimensions and electrical properties similar to clinically relevant lumenless leads (LLLs) for use in LBBA pacing. Methods: Insulated 125 μm silver wires were fixed along a 3-dimensional printed MEL shaft. Wires were wrapped circumferentially at distal, medial, and proximal sites (0.4 mm apart), secured with polyimide, and deinsulated by sanding. The MEL tip was cut into a bevel shape to facilitate septal insertion. MEL has 5.4 mm Results: MEL and LLL had similar impedance and capture voltages. MEL's multiple pacing options evoked QRS morphology changes with pacing output and location. MEL more often detected a narrower QRS at insertion than LLL (LLL, 114 ms; quartile [Q]1-Q3, 98-120 ms; MEL, 82 ms; Q1-Q3, 68-98 ms; Conclusion: MELs more often evoked electrocardiogram markers indicative of conduction system capture during LBBA pacing, suggesting that MELs may streamline implantation, reduce lead repositioning, and advance conduction system pacing strategies.
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