Department of Cardiology, Hwa Mei Hospital, University of Chinese Academy of Sciences, 41 Xibei Street, Ningbo, 315010, Zhejiang, China.
Department of Biology, Integrated Science Center, College of William and Mary, Williamsburg, VA, USA.
J Interv Card Electrophysiol. 2023 Jun;66(4):865-872. doi: 10.1007/s10840-022-01203-2. Epub 2022 Apr 1.
It was recently shown that template beats and fixation beats of the premature ventricular contractions (PVCs) were generated during lead deployment. These could be exploited to guide the left bundle branch (LBB) pacing (LBBP) procedure. However, lack of a revolving connector that can continuously record and pace during lead rotations has been a limitation when using the traditional implant technique. Here, we report ten cases in which a revolving connector was used and showed that the premature beats of selective left bundle branch (SLBB-PBs) were generated as the lead was reached and the electrical stimulus selectively captured the LBB.
Ten patients who underwent the transseptal placement of the pacing lead using a revolving connector were included in the study. We aimed to examine whether the SLBB-PB was a marker of LBB capture during LBBP and the clinical significance of SLBB-PB. LBBP was performed and data of these cases were analyzed to show the characteristics of the electrocardiogram and the intracardiac electrogram of SLBB-PBs.
This is the first case series on SLBB-PBs in LBBP. The presence of SLBB-PBs suggested that the LBB was reached and selectively captured and possibly increased the safety of lead implantation.
最近有研究表明，室性早搏（PVC）的模板搏动和固定搏动是在导联植入过程中产生的。这些可以被利用来指导左束支（LBB）起搏（LBBP）程序。然而，在使用传统植入技术时，缺乏一种能够在导联旋转时持续记录和起搏的旋转连接器，这一直是一个限制。在这里，我们报告了使用旋转连接器的 10 例病例，这些病例显示选择性左束支（SLBB-PB）的早期搏动是随着导联的到达而产生的，电刺激选择性地捕获了 LBB。
这项研究纳入了 10 名使用旋转连接器行经间隔穿刺植入起搏导联的患者。我们旨在检验 SLBB-PB 是否是 LBBP 期间 LBB 捕获的标志，以及 SLBB-PB 的临床意义。进行了 LBBP，并对这些病例的数据进行了分析，以显示 SLBB-PB 的心电图和心内电图特征。
这是首例关于 LBBP 中 SLBB-PB 的病例系列研究。SLBB-PB 的存在提示 LBB 已经到达并被选择性地捕获，可能增加了导联植入的安全性。
