Evidence map›Paper›PMID 41953997›Full record

ArticleCirculation. Arrhythmia and electrophysiology2026

Delivery System Support Prevents Endocardial Entanglement and Delamination During Left Bundle Branch Area Pacing.

Yuichiro Miyazaki, Hiroshi Nakajima, Mark Rimmer, Peter Hanna, Justin H Hayase, Duc H Do, Kalyanam Shivkumar, Shumpei Mori

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PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Arrhythmia and electrophysiology, 2026. 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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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yuichiro MiyazakiDivision of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California Los Angeles (UCLA) (Y.M., M.R., P.H., J.H.H., D.H.D., K.S., S.M.).ORCID 0000-0003-0407-7286
Hiroshi NakajimaDepartment of Cardiology, Chiba-Nishi General Hospital, Matsudo, Chiba, Japan (H.N.).ORCID 0000-0001-5390-4511
Mark RimmerDivision of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California Los Angeles (UCLA) (Y.M., M.R., P.H., J.H.H., D.H.D., K.S., S.M.).ORCID 0009-0004-3893-1158
Peter HannaDivision of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California Los Angeles (UCLA) (Y.M., M.R., P.H., J.H.H., D.H.D., K.S., S.M.).ORCID 0000-0003-3092-5090
Justin H HayaseDivision of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California Los Angeles (UCLA) (Y.M., M.R., P.H., J.H.H., D.H.D., K.S., S.M.).ORCID 0000-0001-9242-3817
Duc H DoDivision of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California Los Angeles (UCLA) (Y.M., M.R., P.H., J.H.H., D.H.D., K.S., S.M.).
Kalyanam ShivkumarDivision of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California Los Angeles (UCLA) (Y.M., M.R., P.H., J.H.H., D.H.D., K.S., S.M.).ORCID 0000-0002-4121-1766
Shumpei MoriDivision of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California Los Angeles (UCLA) (Y.M., M.R., P.H., J.H.H., D.H.D., K.S., S.M.).ORCID 0000-0002-5803-7135

Funding

Neural Control of Myocardial Excitability at the Nerve Myocyte InterfaceP01HL164311 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI KALYANAM SHIVKUMAR · 2023 to 2026
$11.3M
NHLBI NIH HHS P01 HL164311
6 · The paper itself

Abstract

backgroundThe mechanisms behind endocardial entanglement and resultant delamination during left bundle branch area pacing, as well as potential solutions, have not been fully demonstrated in the human heart.

methodsActive fixation of a lumenless screw-in lead into the right ventricular septum was attempted with or without delivery system support using donor human hearts rejected for transplant. Delivery sheath support was ensured through firm catheter support maintained by a fixed clip. Endocardial entanglement, endocardial delamination after unscrewing, and lead penetration were evaluated using both macroscopic and microscopic analyses.

resultsEach of 10 lead deployments with or without support was attempted using 4 donor human hearts. There was a higher incidence of endocardial entanglement and resultant helix-only penetration in the nonsupport group than the support group (70% versus 0%). Unscrewing after the endocardial entanglement consistently revealed extensively delaminated endocardium entwined around the helix. The median endocardial delamination area was larger in the entanglement group than in the nonentanglement group (25.0 mm

conclusionsEndocardial entanglement and delamination were confirmed in donor human hearts. Adequate delivery system support, particularly its coaxiality and counterforce effect, is likely to prevent endocardial entanglement and facilitate effective penetration of a lumenless screw-in lead into the human ventricular septum.

Indexed as

Bundle of HisCardiac Pacing, ArtificialEndocardiumPacemaker, ArtificialFemaleHumansMaleMiddle Agedanatomycardiac pacing, artificialheart conduction systemhistologyhumans

Identifiers

PMID41953997
PMCPMC13078700

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.