Melpignano Angelo, Vitali Francesco, Canovi Luca, Bonini Jacopo, Vocale Ludovica Rita, Bertini Matteo
Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, 44124 Ferrara, Italy.
J Cardiovasc Dev Dis. 2025 Aug 3;12(8):299. doi: 10.3390/jcdd12080299.
Anodal capture, characterized by a different QRS morphology compared to cathodal capture, is a well-known issue in cardiac resynchronization therapy (CRT). Left bundle branch area pacing (LBBAP), a novel physiological pacing technique, is also used as a bailout strategy following failed conventional CRT implantation. In LBBAP, QRS transition, defined by a change in paced QRS morphology, serves as a key marker of successful lead placement. This case report is the first to document both high-output anodal capture and LBBAP-induced QRS transition in a single individual receiving LBBAP with an implantable cardioverter-defibrillator (ICD) as a bailout strategy for failed cardiac resynchronization therapy with defibrillator (CRT-D) implantation. Their coexistence underscores unique device optimization challenges in this emerging approach.
阳极夺获是心脏再同步治疗（CRT）中一个众所周知的问题，其特征是与阴极夺获相比QRS形态不同。左束支区域起搏（LBBAP）是一种新型的生理性起搏技术，也被用作传统CRT植入失败后的补救策略。在LBBAP中，由起搏QRS形态变化定义的QRS转换是导线成功放置的关键标志。本病例报告首次记录了在一名接受LBBAP并植入植入式心律转复除颤器（ICD）作为心脏再同步除颤治疗（CRT-D）植入失败补救策略的个体中同时出现高输出阳极夺获和LBBAP诱导的QRS转换。它们的共存凸显了这种新兴方法中独特的设备优化挑战。
