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Interesting phenomena during threshold testing of conduction system pacing: What is the mechanism?

作者信息

Shen Jiabo, Jiang Longfu, Wu Hao, Pan Lifang

机构信息

Department of Cardiology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China.

Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China.

出版信息

Pacing Clin Electrophysiol. 2023 Apr;46(4):319-322. doi: 10.1111/pace.14600. Epub 2022 Oct 10.

DOI:10.1111/pace.14600
PMID:36193871
Abstract

BACKGROUND

Although the interest in conduction system pacing is increasing, the data on longitudinal dissociation in the literature is still limited. METHODS AND RESULTS: We performed left bundle branch (LBB) pacing on a patient with sick sinus syndrome and atrioventricular block. The transition of QRS morphology can be observed during the threshold testing. The main findings were different left ventricular activation times when selective LBB capture was performed at different outputs.

CONCLUSIONS

This phenomenon may be due to the anatomical basis of longitudinal dissociation of the His-Purkinje system, which allows pacing stimulation at different thresholds to excite different portions of the conduction system.

摘要

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