ArticleFrontiers in cardiovascular medicine2025
Role of peri-deployment right ventricular paced-ECG in left bundle area pacing.
Article in Frontiers in cardiovascular medicine, 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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1 citing paper in PubMed.
- Tissue attached to retrieved left bundle pacing leads: histopathological evaluation of tissue composition in relation to difficult lead advancement.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
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10 authors.
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Abstract
Background: Left bundle area pacing (LBBAP) has emerged as a promising physiological pacing modality. The current technique for LBBAP lead implantation predominantly relies on the anatomy of the His bundle and right ventricular septum. While practical, this anatomical approach can lead to variations in lead polarity and QRS durations due to the relatively extensive target zone. Objectives: This study aims to investigate whether peri-deployment paced ECGs can effectively guide LBBAP and enhance left ventricular activation. Methods: We conducted a retrospective analysis of 41 patients (54 attempts) who underwent LBBAP between 1 September 2020 and 30 June 2021. We collected and analyzed demographic data, baseline ECGs, intraprocedural ECGs, and ventricular local electrograms. QRS patterns were categorized into five common types, R, Rs, rs, rS, and S, and were labeled from 1 to 5 for polarity analysis. In addition, we explored markers associated with achieving shorter QRS durations (<120 ms). Results: LBBAP was successfully achieved in 81.5% of the attempts. During the procedure, the paced QRS duration (QRSd) significantly decreased from 144.5 ± 22.6 ms-128.8 ± 22.9 ms ( Conclusions: Peri-deployment ECG assessment is a practical adjunct to anatomy-based LBBAP, providing real-time markers for optimal lead positioning. Specifically, an unaltered lead II axis and expected changes in the lead I/aVL and lead III/aVF axes can help guide the selection of the left bundle branch. Lower pre-deployment paced QRSd and LVAT, as well as a more rightward inferior axis after deployment, are associated with a shorter post-deployment QRSd.
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