Publication
Title
Left Bundle Branch Area Defibrillator (LBBAD) : a first-in-human feasibility study
Author
Abstract
BACKGROUND Left bundle branch area (LBBA) pacing is a promising pacing technique. LBBA implantable cardioverter-defibrillator (ICD) lead implantation reduces the number of leads in patients with both pacing and ICD indications, reducing cost and potentially increasing safety. LBBA positioning of ICD leads has not previously been described. OBJECTIVES The goal of this study was to evaluate the safety and feasibility of implanting an LBBA ICD lead. METHODS This prospective, single-center, feasibility study was conducted in patients with an ICD indication. LBBA ICD lead implantation was attempted. Acute pacing parameters and paced electrocardiography data were collected, and defibrillation testing was performed. RESULTS LBBA defibrillator (LBBAD) implantation was attempted in 5 patients (mean age 57 & PLUSMN; 16.5 years; 20% female) and achieved in 3 (60%). Mean procedural and fluoroscopy duration were 170.0 & PLUSMN; 17.3 minutes and 28.8 & PLUSMN; 16.1 minutes, respectively. Left bundle capture was achieved in 2 patients (66%) and left septal capture in 1 patient. LBBA pacing exhibited a mean QRS duration and V6 R-wave peak time of 121.3 & PLUSMN; 8.3 milliseconds and 86.1 & PLUSMN; 10.0 milliseconds. In all 3 patients, defibrillation testing was successful with mean time to adequate shock delivery of 8.6 & PLUSMN; 2.6 seconds. Acute LBBA pacing threshold and R-wave amplitudes were 0.80 & PLUSMN; 0.60 V at 0.4 milliseconds and 7.0 & PLUSMN; 2.7 mV. No LBBA lead-related complications occurred. CONCLUSIONS This first-in-human evaluation showed the feasibility of LBBAD implantation in a small cohort of patients. With current tools, implantation remains complex and time-consuming. Considering the feasibility reported and the potential benefits, further technological development in this field is warranted with evaluation of long-term safety and performance. (J Am Coll Cardiol EP 2023;9:620-627) & COPY; 2023 by the American College of Cardiology Foundation.
Language
English
Source (journal)
JACC: Clinical Electrophysiology. - -
JACC. Clinical electrophysiology. - [New York], 2015, currens
Publication
2023
ISSN
2405-500X
DOI
10.1016/J.JACEP.2023.01.006
Volume/pages
9 :5 (2023) , p. 620-627
ISI
001053572900001
Pubmed ID
37225308
Full text (Publisher's DOI)
UAntwerpen
Faculty/Department
Research group
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identifier
Creation 02.10.2023
Last edited 04.03.2024
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