Comparative of stylet-driven versus lumenless technique for left bundle branch pacing: implant results and follow-up outcomes
| Autor: | J Ramos Jimenez, A Marco Del Castillo, N Paredes Hurtado, DA Rodriguez Munoz, A Fontenla, L Borrego Bernabe, M Lopez Gil, R Salguero Bodes, F Arribas Ynsaurriaga |
|---|---|
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | EP Europace. 24 |
| ISSN: | 1532-2092 1099-5129 |
| Popis: | Funding Acknowledgements Type of funding sources: None. Introduction Left bundle branch pacing (LBBP) has traditionally been performed with fixed helix lumenless leads. The aim of this work is to compare feasibility and results with an extendable helix stylet-driven lead. Methods Unicenter and prospective registry of consecutive cases where LBBP was attempted using 2 different systems: -B: stylet-driven extendable helix lead guided with preshaped delivery sheath. -M: lumenless and fixed helix lead guided with preshaped delivery sheath. Anthropometric, echocardiographic, procedural variables and long-term performance were compared using T-test for continuous variables, and chi-squared for categorical ones. A two-tailed p value Results 134 patients were included. 44% (n=59) underwent the B technique and 56% (n=75) the M technique. Table 1 summarizes baseline, procedural and follow-up results. Implant failed in 4 (6.8%) patients in the B group: 2 because of repetitive entanglement of the helix with the endocardial surface, and 2 because of dislodgment of the lead after slitting the sheath. In the M group only 1 (1.3%) implant failed due to endocardial entanglement precluding correct penetration into the septum. Of the successfully implanted leads, 78.2% (n=43) in the B group vs. 70.3% (n=52) of the M group fulfilled strict LBB capture criteria (p=0.31). Baseline characteristics, fluoroscopy and procedure time showed no differences. After a median device follow-up time of 66 (interquartile range 36-184) days, slightly inferior capture threshold was seen in M group. 2 patients (3.8%) of the B group showed a threshold increase >2.0V, one of them needing intervention due to lack of capture. All M leads performed well during follow-up. Conclusions In consecutive patients with comparable baseline characteristics, both B and M technique are equally feasible, with similar LBBP success, procedural outcomes and long-term performance. Larger registries are needed to assess whether implant and long-term failure are also comparable. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|