Initial Experience, Safety, and Feasibility of Left Bundle Branch Area Pacing: A Multicenter Prospective Study.

TL;DR: A 2021-es ESC pacemaker- és CRT-ajánlásban a „pace and ablate” stratégia hangsúlyos szerepet kapott as mentioned in this paper was a közelmúltban elérhetővé vált 3D-görbületű sheath-tel elvégzett, bal Tawara-szár területi ingerlés (LBBA-pace) és egy ülésben kivitelezett AV-csomó-abláció esetét mutatjuk be.

TL;DR: A case of complete atrioventricular block (AVB) with Ebstein’s anomaly and successful LBBAP from the functional right atrium is reported.

TL;DR: CSP may be an alternative therapy to CRT for patients with PICM due to its lower thresholds, and HBP would be a better choice than HBP due to its lower thresholds.

TL;DR: In this paper , the authors focus on the anatomy of the conduction system and the clinical feasibility of pacing the His bundle and/or left bundle conduction systems and compare the evolving role of conduction-system pacing with biventricular pacing.

TL;DR: The case shows a novel pacing strategy for patients with BBB that affects many patients with heart failure, and demonstrates the feasibility of pacing the left bundle branch (LBB) immediately beyond the conduction block to functionally restore the impaired His-Purkinje conduction system.

Abstract: Introduction Studies have demonstrated the feasibility and clinical benefits of permanent His-bundle pacing (HBP). However, concerns regarding higher pacing thresholds, lower R-wave amplitudes, and the potential to develop distal conduction block have limited the clinical application of HBP in certain subgroups. Thus, left bundle branch pacing (LBBP) has emerged as an alternative method for delivering physiological pacing to achieve electrical synchrony of the left ventricle (LV), especially in patients with infranodal atrioventricular block and left bundle branch block (LBBB). The proximal left bundle branches run through the LV septum and fan out to form a wider target for pacing compared to the His bundle. Recently, we reported that HBP can correct classic LBBB in 97% of patients, and Upadhyay et al demonstrated that the site of block usually is located within the His or proximal left bundle. We developed a technique for LBBP using a transseptal approach. LBBP has been reported to offer low pacing thresholds and large R waves, and because the distal conduction system is targeted, has a lower theoretical risk for development of distal conduction block. However, the definitions and implantation procedure have not been previously well described. Here we describe our method for performing LBBP to confirm intraseptal left con-

TL;DR: Permanent HBP was feasible and safe in a large real-world population requiring permanent pacemakers and was associated with reduction in the combined endpoint of death, HFH, or upgrade to BiVP compared to RVP in patients requiring permanentpacemakers.

TL;DR: HBP and LBBAP may significantly increase the overall success of physiologic pacing and be feasible in a high percentage of patients with low thresholds during acute follow-up.