Lead Performance and Echocardiographic Outcomes for Delayed Bundle Capture Loss During Conduction System Pacing.

IF 1.7 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Pace-Pacing and Clinical Electrophysiology Pub Date : 2025-04-01 Epub Date: 2025-03-18 DOI:10.1111/pace.15178
Shengjie Wu, Lan Su, Yuchao Fang, Wenxuan Shang, Xinxin Wang, Junwei Wang, Lei Xu, Songjie Wang, Weijian Huang
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引用次数: 0

Abstract

Background: Conduction system pacing (CSP) is increasingly recognized for mitigating the adverse hemodynamic effects commonly associated with conventional ventricular pacing. However, there is limited data on the lead performance and echocardiographic outcomes for delayed bundle capture loss during CSP.

Objective: To evaluate the rate of complete loss of bundle capture/correction during CSP and assess the subsequent clinical outcomes.

Method: Patients who underwent successful CSP lead implantation with indications for ventricular pacing or cardiac resynchronization therapy (CRT) were screened. The reasons for complete loss of capture or failed LBBB correction were identified, and subsequent clinical outcomes were analyzed.

Result: Out of 2636 patients screened, nine experienced complete loss of bundle capture or LBBB correction during follow-up. Loss of capture was attributed to unexplained causes (n = 6), near-complete electrode dislodgement (n = 1), surgical damage (n = 1), and electrode malfunction (n = 1). The six patients with CRT indication and declining cardiac function underwent lead revision, with left ventricular ejection fraction (LVEF) improving from 40.6 ± 17.3% to 59.1 ± 6.0% at the last follow-up with the bundle capture threshold of 0.63 ± 0.14 V/0.5 ms. The remaining 3 atrioventricular block patients with stable cardiac function did not undergo lead revision and the local myocardium threshold of 0.58± 0.31 V/0.5 ms.

Conclusion: The incidence of complete capture loss during CSP is low recapturing/recorrecting the bundle significantly improves cardiac function in patients with CRT indications.

传导系统起搏时延迟束捕获丢失的导联性能和超声心动图结果。
背景:传导系统起搏(CSP)越来越被认为可以减轻通常与传统心室起搏相关的不良血流动力学影响。然而,关于CSP期间延迟束捕获丢失的导联性能和超声心动图结果的数据有限。目的:评估CSP中束捕获/矫正完全丢失的比率,并评估随后的临床结果。方法:筛选有心室起搏或心脏再同步化治疗适应症的CSP导联植入成功的患者。确定完全丧失捕获或LBBB矫正失败的原因,并分析随后的临床结果。结果:在筛选的2636名患者中,9名患者在随访期间完全失去了束捕获或LBBB矫正。捕获丢失原因不明(n = 6),电极几乎完全脱位(n = 1),手术损伤(n = 1)和电极功能障碍(n = 1)。6例CRT适应症和心功能下降的患者进行了导联修复,左室射血分数(LVEF)从40.6±17.3%改善到59.1±6.0%,最后一次随访时束捕获阈值为0.63±0.14 V/0.5 ms。其余3例心功能稳定的房室传导阻滞患者未行导联修正,局部心肌阈值为0.58±0.31 V/0.5 ms。结论:CSP过程中完全俘获丢失的发生率较低,重捕/重捕束明显改善了CRT指征患者的心功能。
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
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.
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