Contrast-enhanced image-guided lead deployment for left bundle branch pacing
| Autor: | Minsi Cai, Michael R. Gold, Min Gu, Hongxia Niu, Xi Liu, Nixiao Zhang, Wei Hua, Xiaohong Zhou, Xuhua Chen, Shu Zhang, Yiran Hu, Junhan Zhao |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Bundle of His media_common.quotation_subject Bundle-Branch Block 030204 cardiovascular system & hematology Electrocardiography 03 medical and health sciences 0302 clinical medicine Heart Rate Physiology (medical) Left bundle branch Humans Medicine Contrast (vision) Prospective Studies 030212 general & internal medicine Lead (electronics) media_common business.industry Cardiac Pacing Artificial Middle Aged Visualization Surgery Computer-Assisted Target site Fluoroscopy Female Electrical conduction system of the heart Cardiology and Cardiovascular Medicine Nuclear medicine business Follow-Up Studies |
| Zdroj: | Heart Rhythm. 18:1318-1325 |
| ISSN: | 1547-5271 |
| DOI: | 10.1016/j.hrthm.2021.04.015 |
| Popis: | Left bundle branch pacing (LBBP) is a novel conduction system pacing modality, but pacing lead deployment remains challenging.This study aimed to evaluate the feasibility of visualization-enhanced lead deployment for LBBP implantation and to assess LBBP characteristics on the basis of lead tip location.Successful LBBP with a well-defined lead tip location by visualization of the tricuspid value annulus in 20 patients was retrospectively analyzed to develop an image-guided technique to identify the LBBP target site. This technique was then prospectively tested in 60 patients who were randomized into 2 groups, one using the standard approach (the standard group) and the other using the image-guided technique (the visualization group). The procedural details, electrophysiological characteristics, and short-term follow-up were compared between groups.LBBP was successfully achieved in 28 patients in the standard group and in 29 in the visualization group. The procedural and fluoroscopic durations in the visualization group (66.76 ± 14.62 and 7.83 ± 2.05 minutes) were significantly shorter than those in the standard group (85.46 ± 20.19 and 11.11 ± 3.51 minutes) (P.01). The number of lead deployment attempts in the visualization group was lower than that in the standard group (2.03 ± 1.18 vs 2.96 ± 1.17; P.01), and the proportion of left bundle branch potential recorded was higher (79.3% vs 46.4%; P = .01).Using a visualization technique, the procedural and fluoroscopic durations for LBBP implantation were significantly shortened with fewer lead repositioning attempts. |
| Databáze: | OpenAIRE |
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