Publication detail

Bipolar anodal septal pacing with direct LBB capture preserves physiological ventricular activation better than unipolar left bundle branch pacing

ČURILA, K. JURÁK, P. PRINZEN, F. JASTRZEBSKI, M. WALDAUF, P. HALÁMEK, J. TÓTHOVÁ, M. ZNOJILOVÁ, L. SMÍŠEK, R. KACH, J. POVIŠER, L. LINKOVÁ, H. PLEŠINGER, F. MOSKAL, P. VIŠČOR, I. VONDRA, V. LEINVEBER, P. OSMANČÍK, P.

Original Title

Bipolar anodal septal pacing with direct LBB capture preserves physiological ventricular activation better than unipolar left bundle branch pacing

Type

journal article in Web of Science

Language

English

Original Abstract

BackgroundLeft bundle branch pacing (LBBP) produces delayed, unphysiological activation of the right ventricle. Using ultra-high-frequency electrocardiography (UHF-ECG), we explored how bipolar anodal septal pacing with direct LBB capture (aLBBP) affects the resultant ventricular depolarization pattern. MethodsIn patients with bradycardia, His bundle pacing (HBP), unipolar nonselective LBBP (nsLBBP), aLBBP, and right ventricular septal pacing (RVSP) were performed. Timing of local ventricular activation, in leads V1-V8, was displayed using UHF-ECG, and electrical dyssynchrony (e-DYS) was calculated as the difference between the first and last activation. Durations of local depolarizations were determined as the width of the UHF-QRS complex at 50% of its amplitude. ResultsaLBBP was feasible in 63 of 75 consecutive patients with successful nsLBBP. aLBBP significantly improved ventricular dyssynchrony (mean -9 ms; 95% CI (-12;-6) vs. -24 ms (-27;-21), ), p < 0.001) and shortened local depolarization durations in V1-V4 (mean differences -7 ms to -5 ms (-11;-1), p < 0.05) compared to nsLBBP. aLBBP resulted in e-DYS -9 ms (-12; -6) vs. e-DYS 10 ms (7;14), p < 0.001 during HBP. Local depolarization durations in V1-V2 during aLBBP were longer than HBP (differences 5-9 ms (1;14), p < 0.05, with local depolarization duration in V1 during aLBBP being the same as during RVSP (difference 2 ms (-2;6), p = 0.52). ConclusionAlthough aLBBP improved ventricular synchrony and depolarization duration of the septum and RV compared to unipolar nsLBBP, the resultant ventricular depolarization was still less physiological than during HBP.

Keywords

Ultra-high-frequency ECG; dyssynchrony; LBBP; anodal septal pacing; His bundle pacing

Authors

ČURILA, K.; JURÁK, P.; PRINZEN, F.; JASTRZEBSKI, M.; WALDAUF, P.; HALÁMEK, J.; TÓTHOVÁ, M.; ZNOJILOVÁ, L.; SMÍŠEK, R.; KACH, J.; POVIŠER, L.; LINKOVÁ, H.; PLEŠINGER, F.; MOSKAL, P.; VIŠČOR, I.; VONDRA, V.; LEINVEBER, P.; OSMANČÍK, P.

Released

22. 3. 2023

Publisher

Frontiers

ISBN

2297-055X

Periodical

Frontiers in Cardiovascular Medicine

Year of study

10

Number

1

State

Swiss Confederation

Pages from

1

Pages to

9

Pages count

9

URL

https://www.frontiersin.org/articles/10.3389/fcvm.2023.1140988/full

Full text in the Digital Library

http://hdl.handle.net/11012/213624

BibTex

@article{BUT183301,
  author="Karol {Čurila} and Pavel {Jurák} and Frits {Prinzen} and Marek {Jastrzebski} and Petr {Waldauf} and Josef {Halámek} and Markéta {Tóthová} and Lucie {Znojilová} and Radovan {Smíšek} and Jakub {Kach} and Lukáš {Povišer} and Hana {Linková} and Filip {Plešinger} and Pawel {Moskal} and Ivo {Viščor} and Vlastimil {Vondra} and Pavel {Leinveber} and Pavel {Osmančík}",
  title="Bipolar anodal septal pacing with direct LBB capture preserves physiological ventricular activation better than unipolar left bundle branch pacing",
  journal="Frontiers in Cardiovascular Medicine",
  year="2023",
  volume="10",
  number="1",
  pages="1--9",
  doi="10.3389/fcvm.2023.1140988",
  issn="2297-055X",
  url="https://www.frontiersin.org/articles/10.3389/fcvm.2023.1140988/full"
}