Left bundle branch area defibrillation using standard stylet-driven leads achieved an 88% implantation success rate and improved LVEF from 30% to 36% (P<0.001) over an 8-month follow-up.
Cohort (n=163)
Yes
Does left bundle branch area defibrillation using standard ICD leads provide safe and effective defibrillation and pacing in patients requiring conduction system pacing?
Left bundle branch area defibrillation using standard stylet-driven ICD leads is feasible and safe, demonstrating stable electrical parameters, effective defibrillation, and improved LVEF at mid-term follow-up.
AbstractBackground Left bundle branch area defibrillation (LBBAD) therapy is currently an off-label procedure. Nevertheless, it is a promising technique that reduces the number of leads in implantable cardioverter defibrillator (ICD) patients who require conduction system pacing. Objectives: to collect real-world data on LBBAD implantation and follow-up. Methods Retrospective periprocedural and follow-up data on electrocardiographic and electrical parameters, transthoracic echocardiography and clinical outcome were assembled from 12 international centres. Results In total, 163 patients (age 67±12 years, 137 males) were included. Implantation success rate was 88%. Defibrillation testing was performed in 85 patients and was effective in all cases. Paced unipolar QRS duration was 125 119-135 ms with a V6R-wave peak-time of 76 70-85 ms, a V6-V1 interpeak interval of 44 45-54 ms. Capture threshold was 0.8 0.5-1.1 V/0.4ms, sensing amplitude was 9.0 6.2-12 mV and pacing and high-voltage impedances were 580 493-650 Ohms and 66 60-75 Ohms. Electrical parameters remained favourable over a follow-up of 8 3-13 months. Left ventricular ejection fraction (LVEF) improved from 30 26-35 % to 36 31-46% at last follow-up (PConclusion LBBAD with standard stylet-driven lead is safe and feasible, with stable electrical, ECG, and echocardiographic parameters at mid-term follow-up.
Imnadze et al. (Sun,) conducted a cohort in ICD patients requiring conduction system pacing (n=163). Left bundle branch area defibrillation (LBBAD) was evaluated on Implantation success rate. Left bundle branch area defibrillation using standard stylet-driven leads achieved an 88% implantation success rate and improved LVEF from 30% to 36% (P<0.001) over an 8-month follow-up.