Evidence map›Paper›PMID 42774462›Full record

ArticleHeart rhythm O22026

The flexibility of delayed fluoroscopic left ventricular angiography in periprocedural real-time visualization of the lead tip in left bundle branch pacing.

Sung-Hao Huang, Wen-Han Cheng, Hsuan-Ming Tsao, Wen-Liang Lin, Dan-Ying Lee, Shih-Ann Chen

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Article in Heart rhythm O2, 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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5 · Who and what money

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6 authors.

Sung-Hao HuangDivision of Cardiology, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan.
Wen-Han ChengSchool of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Hsuan-Ming TsaoDivision of Cardiology, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan.
Wen-Liang LinDivision of Radiology, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan.
Dan-Ying LeeDivision of Cardiology, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan.
Shih-Ann ChenSchool of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Current electrocardiography and electrogram (EGM) criteria for confirming left bundle branch (LBB) capture may be inconclusive in certain clinical scenarios. Real-time imaging methods to evaluate lead positioning during LBB pacing (LBBP) remain limited. Objective: This study aimed to evaluate the feasibility of delayed fluoroscopic left ventricular (LV) angiography (LVG) for real-time visualization of lead position during LBBP. Methods: Patients undergoing LBB area pacing with delayed LVG were classified as LBBP or LV septal pacing (LVSP) according to EGM-based capture criteria. LBB capture was identified by fascicular potentials, morphology transitions, or a stepwise electrocardiography/EGM algorithm; lead tip-to-LV and right ventricular septal border distances were measured at end-systole and end-diastole, with right ventricular distance representing total lead insertion length. Results: 76 patients were included (LBBP n = 51; LVSP n = 25). Pacing threshold, impedance, R-wave amplitude, and stimulus-to-V6 LV activation time did not differ significantly between the groups. The QRS onset to V6 LV activation time was shorter in the LBBP group than the LVSP group (33.3 ± 10.6 ms vs 41.4 ± 12.9 ms; Conclusion: Delayed LVG provides a practical intraprocedural imaging method as an adjunct for real-time visualization of lead position during LBBP, particularly when capture criteria are uncertain.

Indexed as

Conduction system pacingFluoroscopeHelix tipLead depthLeft bundle branch captureLeft bundle branch pacing

Identifiers

PMID42774462
PMCPMC13594496

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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.