Closed loop stimulation in left bundle branch area pacing.

IF 1.7 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Pace-Pacing and Clinical Electrophysiology Pub Date : 2024-09-01 Epub Date: 2024-06-08 DOI:10.1111/pace.15022

Gabriele Dell'Era, Chiara Ghiglieno, Federica De Vecchi, Matteo Santagostino, Lucia Annunziata, Irene Baldassarre, Daniele Giacopelli, Giuseppe Patti

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引用次数: 0

Abstract

Introduction: Closed Loop Stimulation (CLS) is a rate-responsive algorithm that adjusts heart rate (HR) based on changes in intracardiac impedance measured from the right ventricle lead. However, the use of CLS in conduction system pacing has not been investigated. In this retrospective study, we aimed to assess whether CLS with left bundle branch area pacing (LBBAP) can generate an appropriate distribution of HR in daily life.

Methods and results: Our study included 24 patients with CLS pacing and chronotropic incompetence, comparing them with 19 patients receiving DDD pacing, all with LBBAP. Cumulative HR distribution charts were generated using data from a single device interrogation with a minimum follow-up period of 30 days. In DDD-CLS mode, there was a higher percentage of atrial pacing compared to DDD mode (median 58% [interquartile range 29%-83%] vs. 13% [10%-26%], p = .001), and CLS-paced beats were present across all frequency bins. The distribution of beats between the groups was similar (p = .643), resulting in comparable mean HR (72 bpm [70-77] vs. 73 bpm [65-75], p = .615).

Conclusions: In the context of LBBAP, CLS effectively modulates pacing rates over a wide frequency range. This lead position does not adversely affect the rate-responsive performance of the algorithm.

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左束支区起搏的闭环刺激。

简介闭环刺激（CLS）是一种速率响应算法，可根据从右心室导联测量到的心内阻抗变化调整心率（HR）。然而，CLS 在传导系统起搏中的应用尚未得到研究。在这项回顾性研究中，我们旨在评估 CLS 配合左束支区起搏（LBBAP）能否在日常生活中产生适当的心率分布：我们的研究纳入了 24 名 CLS 起搏和chronotropic incompetence 患者，并将他们与 19 名接受 DDD 起搏的患者进行了比较，所有患者都接受了 LBBAP 起搏。我们使用单个设备询问的数据生成了累计心率分布图，随访时间最短为 30 天。在 DDD-CLS 模式中，心房起搏的比例高于 DDD 模式（中位数 58% [四分位间范围 29%-83%] vs. 13% [10%-26%]，p = .001），CLS 起搏出现在所有频段。两组间的节拍分布相似（p = .643），因此平均心率相当（72 bpm [70-77] vs. 73 bpm [65-75]，p = .615）：结论：在 LBBAP 的情况下，CLS 可在较宽的频率范围内有效调节起搏率。这种导联位置不会对算法的速率响应性能产生不利影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pace-Pacing and Clinical Electrophysiology 医学-工程：生物医学

CiteScore

2.70

自引率

5.60%

发文量

209

审稿时长

2-4 weeks

期刊介绍： Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.