Pace-Pacing and Clinical Electrophysiology最新文献

{"title":"Caught in the Act: A Detailed Analysis of Cardiac Event Monitoring in a Cohort of Pediatric and ACHD Patients.","authors":"Ashwin Srivatsav, Zachery J Thompson, Michael A Bruno, Sara B Stephens, Maria Elena Gutierrez, Christina Y Miyake, Shaine A Morris, Tam Dan Pham, Santiago O Valdes, Jeffrey J Kim, Taylor S Howard","doi":"10.1111/pace.15087","DOIUrl":"10.1111/pace.15087","url":null,"abstract":"<p><strong>Background: </strong>Event monitors are being increasingly used in pediatric and adult congenital heart disease (ACHD) patients for arrhythmia evaluation. Data on their diagnostic yield are limited.</p><p><strong>Objectives: </strong>To evaluate the diagnostic yield of event monitors, patient characteristics associated with critical events, and clinical response to events.</p><p><strong>Methods: </strong>We retrospectively assessed event monitors prescribed to patients at our institution's Heart Center from 2017 to 2020. Thirty-day event monitor tracings were reviewed by an electrophysiologist (EP) to identify critical events defined as supraventricular tachycardia (SVT, re-entrant, atrial tachycardia, atrial flutter, and atrial fibrillation), ventricular tachycardia (VT), atrioventricular block, and pauses greater than 3 s. Patient characteristics and treatment data were collected. Characteristics associated with events were assessed using multivariable logistic regression. Trends in monitor prescription over time, diagnostic yield, and clinical response to events were analyzed.</p><p><strong>Results: </strong>204/2330 (8.8%) event monitors had EP-confirmed critical events. Critical events included SVT (51.5%), VT (38.5%), atrioventricular block (4%), and pauses (6%). 129/198 (65%) patients with critical events underwent treatment. Event monitoring usage increased by 52% between 2017 and 2020 (p < 0.0001). Complex CHD (OR 2.1, 95% CI 1.3-3.4, p = 0.004), cardiomyopathy (OR 2.9, 95% CI 1.5-4.8, p < 0.001), and EP-ordered monitors (OR 1.6, 95% CI 1.2-2.1, p = 0.001) were more highly associated with critical events.</p><p><strong>Conclusion: </strong>Event monitor use is common, and critical events were captured in 8.8% of patients. The majority of patients with critical events underwent treatment. Factors associated with critical events include EPs as ordering providers, complex CHD, and cardiomyopathy.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"1593-1603"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of Burst Pacing Inducibility Post-Radiofrequency Versus Cryoablation for Paroxysmal Atrial Fibrillation.","authors":"Satoru Sekimoto, Kenta Hachiya, Taku Ichihashi, Takayuki Yoshida, Yasuaki Wada, Yoshimasa Murakami, Yoshihiro Seo","doi":"10.1111/pace.15092","DOIUrl":"10.1111/pace.15092","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) inducibility with burst pacing (BP) after radiofrequency ablation (RFA) has been reported to be associated with AF recurrence. In contrast, the relevance of inducibility and recurrence after cryoablation (CRA) is unclear.</p><p><strong>Methods: </strong>We investigated 367 patients undergoing initial ablation for paroxysmal AF (RFA: 174, CRA: 193). Propensity score matching was conducted, retaining 134 patients in each group. Following pulmonary vein isolation (PVI), the inducibility by BP was tested. Inductions at 250 ppm were defined as low-frequency burst pacing (LFBP) positive, and those at 300 ppm were classified as medium-frequency burst pacing (MFBP) positive. They were followed for 600 days.</p><p><strong>Results: </strong>Forty-eight patients (18%) had AF recurrence. There was no significant difference in the recurrence rate between RFA and CRA (17% vs. 19%, Log-rank p = 0.79). In RFA, significant differences were observed for both LFBP (Log-rank p < 0.001) and MFBP (Log-rank p < 0.001). In contrast, in CRA, there were no significant differences for either LFBP (Log-rank p = 0.39) or MFBP (Log-rank p = 0.19). Multivariable analysis revealed that LFBP-positive (hazards ratio [HR] = 5.75, 95% confidence interval [CI] 2.41-13.7, p < 0.001) was an independent predictor for recurrence with RFA. Acute reconnection (HR = 2.73, 95% CI 1.13-6.56, p = 0.025) was an independent predictor for recurrence with CRA.</p><p><strong>Conclusion: </strong>The inducibility by BP after RFA predicted recurrence at both low and medium frequencies. LFBP-positive was an independent predictor of recurrence in multivariable analysis. In contrast, the inducibility by BP after CRA was not a predictor of recurrence.</p><p><strong>Trail registration: </strong>This study did not require clinical trial registration.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"1650-1659"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Conversion of a Long RP to Short RP Tachycardia: What Is the Mechanism?","authors":"Suresh Allamsetty, Chin-Yu Lin, Yenn-Jiang Lin, Shih-Ann Chen","doi":"10.1111/pace.15094","DOIUrl":"10.1111/pace.15094","url":null,"abstract":"","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"1611-1613"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Atrial Premature Complexes in Exercise Test in Predicting Atrial Fibrillation in Patients Without Obstructive Coronary Artery Disease.","authors":"Ozan Tezen, Levent Pay, Ahmet Çağdaş Yumurtaş, Tuğba Çetin, Semih Eren, Melih Öz, Cahit Coşkun, Cemre Karabacak, Birkan Yenitürk, Tufan Çınar, Mert İlker Hayıroğlu","doi":"10.1111/pace.15090","DOIUrl":"10.1111/pace.15090","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is usually triggered by frequent atrial premature complexes (APC) and atrial tachycardias originated in the pulmonary veins. The aim of the current study is to clarify the relationship between AF and APCs observed during treadmill exercise testing through long-term patient follow-up.</p><p><strong>Material and methods: </strong>Our study only examined the data of patients who did not have any obstructive coronary artery disease and had an exercise test. In total, 1559 patients were included in this research. The study data were divided into two groups according to the development of AF during follow-up. The patients who developed any type of AF during the follow-up period were classified as AF (+). Mean follow-up time for AF (+) and (-) groups were 48 and 47 months, respectively.</p><p><strong>Results: </strong>In the univariable analysis, age, LAAP, and the presence of APCs (HR: 3.906, 95% CI: 2.848-5.365, p < 0.001) during the treadmill exercise test were significantly associated with the development of AF. In the multivariable analysis, age (adjusted HR: 1.063, 95% CI: 1.043-1.083, p < 0.001) and the presence of APCs during the treadmill exercise test (adjusted HR: 2.504, 95% CI: 1.759-3.565, p < 0.001) emerged as independent risk factors for the development of AF. The AF-free survival was significantly lower in the APCs (+) patients compared with the APCs (-) patients (log rank p < 0.001).</p><p><strong>Conclusion: </strong>Our study revealed that individuals without obstructive CAD who exhibited frequent APCs during treadmill exercise tests were more likely to develop AF.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"1586-1592"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Electrical Parameters and Cardiac Synchrony in Patients Underwent Left Bundle Branch Area Pacing.","authors":"Manxin Lin, Shufen Huang, Xinyi Huang, Jincun Guo, Linlin Li, Simei Chen, Guiyang Li, Qiang Li, Dong Chang, Maolong Su, Binni Cai","doi":"10.1111/pace.15095","DOIUrl":"10.1111/pace.15095","url":null,"abstract":"<p><strong>Purpose: </strong>The study aims to assess cardiac synchrony under different left bundle branch area pacing (LBBAP) and evaluate the relationship between different surface or intracardiac electrical parameters and mechanical synchrony.</p><p><strong>Methods: </strong>Eighty-two patients with successful LBBAP were recruited. The electrical synchrony, evaluated by paced QRS duration (pQRSD) and Stim-LVAT (stimulus to left ventricular activation time), and mechanical synchrony, evaluated by the standard deviation of the time-to-peak contraction velocity in 12 left ventricular segments (Tsd-12-LV), were compared between groups in patients underwent LBBAP. To investigate the relationship between different electrical parameters with mechanical synchrony under LBBAP, patients were divided into subgroups according to left ventricular activation time (LVAT, < 60, 60-70, and > 70 ms), presence of left bundle branch (LBB) potential (positive, negative), QRS axis (normal, left axis deviation [LAD]), and potential to ventricular interval (PVI, < 20 and > 20 ms). Mechanical synchrony was compared among the subgroups respectively 3 days post LBBAP procedure.</p><p><strong>Results: </strong>No statistically significant differences were documented in electrical synchrony, evaluated by pQRSD, and mechanical synchrony, evaluated by Tsd-12-LV among the subgroups divided by the stim-LVAT, LBB potential, PVI duration, or paced QRS axis in the LBBAP group.</p><p><strong>Conclusions: </strong>LBB potential, PVI, or normal paced QRS axis is not the prerequisite for successful LBBAP and optimal cardiac synchrony. Adopting a Stim-LVAT value of less than 75 ms to attain ideal electrical and mechanical synchrony during the LBBAP procedure may be applicable.</p><p><strong>Trial registration: </strong>http://www.chictr.org.cn/index.aspx.</p><p><strong>Clinicaltrials: </strong>gov identifier: ChiCTR1800021104.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"1679-1687"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a Triple Antiarrhythmic Drug Strategy for Arrhythmia Recurrence after Persistent Atrial Fibrillation Ablation.","authors":"Shuyu Jin, Haowei Chen, Xianhong Fang, Hongtao Liao, Xianzhang Zhan, Lu Fu, Junrong Jiang, Xingdong Ye, Huiyi Liu, Yanlin Chen, Sijia Pu, Shulin Wu, Hai Deng, Weidong Lin, Yumei Xue","doi":"10.1111/pace.15083","DOIUrl":"10.1111/pace.15083","url":null,"abstract":"<p><strong>Background and objective: </strong>Treating recurrent atrial arrhythmias after persistent atrial fibrillation (PeAF) ablation is often challenging. This single-center, prospective study aimed to observe the effectiveness of different combinations of oral antiarrhythmic drugs (AADs) in reverting to sinus rhythm (SR) in patients with recurrent atrial arrhythmias after PeAF ablation.</p><p><strong>Methods: </strong>Forty-five patients who experienced recurrent atrial arrhythmias after PeAF ablation were included. Based on their medication regimens, patients were divided into two groups, with the study group being a triple-drug group (digoxin combined with amiodarone/ propafenone and β-blocker), and the control group being a non-triple-drug group.</p><p><strong>Results: </strong>The rate of reversion to SR was significantly higher in the study group (n = 29) than in the control group (n = 16) at 3 weeks (34.48% vs. 0%, p < 0.01) and 1 month (44.84% vs. 6.25%, p = 0.02) after initiating AADs. No patients with asymptomatic bradycardia were observed in either group.</p><p><strong>Conclusions: </strong>For patients with recurrent atrial arrhythmias after PeAF ablation, a regimen of low-dose digoxin combined with amiodarone/propafenone and β-blocker may effectively improve short-term reversion rates.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"1642-1649"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Voltage-Guided and Non-Voltage-Guided Superior Vena Cava Isolation in Patients With Atrial Fibrillation.","authors":"Jumpei Saito, Kato Daiki, Sato Hirotoshi, Toshihiko Matsuda, Yui Koyanagi, Katsuya Yoshihiro, Yuma Gibo, Ishigaki Shigehiro, Soichiro Usumoto, Wataru Igawa, Toshitaka Okabe, Naoei Isomura, Masahiko Ochiai","doi":"10.1111/pace.15093","DOIUrl":"10.1111/pace.15093","url":null,"abstract":"<p><strong>Background: </strong>In addition to the pulmonary vein, the superior vena cava (SVC) is an important focus of atrial fibrillation (AF). However, SVC isolation may cause serious complications, and appropriate settings and techniques for SVC isolation are lacking.</p><p><strong>Methods: </strong>This study enrolled 86 consecutive patients with AF who underwent SVC isolation. Voltage mapping using a multi-electrode catheter and ablation were performed under the guidance of an electro-anatomical mapping system. The lines encircling the SVC were divided into eight anatomic segments on the SVC geometry, and each segment was subjected to voltage-guided (VG) ablation in decreasing order of voltage (starting from the segment with the highest voltage). Non-VG (NVG) ablation was performed anatomically from the anterior wall toward the septum with one-round cautery.</p><p><strong>Results: </strong>A total of 86 cases (66 males, mean age 69 [60, 74], mean CHA₂DS₂ VASc score 2 [1, 3], 58 paroxysmal AF) with AF were included for ablation. Electrical SVC isolation was successfully achieved in all patients. The length of the myocardial sleeves, as measured from the SVC-RA junction to the end of the local signal, was 37 [28, 45] mm. Major axis of the RA-SVC junction was 15 [13, 17] and minor axis of the RA-SVC junction was 11 [9, 13]. The number of ablation points with VG SVC isolation was fewer than that for NVG SVC isolation (8 [5, 11.5] vs. 11.5 [8.8, 13.3]; p = 0.001). The procedure time of VG SVC isolation was greater than that of NVG SVC isolation (259 s [154, 379] vs. 167 s [115, 222]; p = 0.012). There were no significant differences in the complication rates.</p><p><strong>Conclusions: </strong>VG SVC isolation reduced the number of ablation points compared with NVG SVC isolation.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"1604-1610"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synthesized V7 QRS Amplitude and Oversensing Episodes in Patients With Subcutaneous Implantable Cardioverter-Defibrillators.","authors":"Takashi Okajima, Shinji Ishikawa, Satoshi Yanagisawa, Takayuki Okamoto, Yusuke Uemura, Kenji Takemoto, Yasuya Inden, Toyoaki Murohara, Masato Watarai","doi":"10.1111/pace.15086","DOIUrl":"10.1111/pace.15086","url":null,"abstract":"<p><strong>Background: </strong>Patients with subcutaneous implantable cardioverter-defibrillators (S-ICDs) experience an oversensing episode (OS) more frequently than those with transvenous ICDs. However, no established electrocardiography (ECG) parameters can accurately detect an OS. This study aimed to evaluate the incidence of an OS in real-world clinical practice and the association of synthesized 18-lead ECG (syn18-ECG) parameters with an OS.</p><p><strong>Methods: </strong>We retrospectively included 21 consecutive patients who underwent S-ICD implantation and collected syn18-ECG parameters. We placed the generator in a deep posterior position and defined an OS as an inappropriate charging episode caused by cardiac or noncardiac signals. A SMART pass filter and two tachyarrhythmia zones were programed.</p><p><strong>Results: </strong>The most frequent underlying heart disease was Brugada/J wave syndrome (n = 7). During a median follow-up period of 1188 days, an OS was observed in six patients (28.6%). The QRS amplitude in synthesized V7 lead (synV7) was significantly lower in the OS group than in the non-OS group (0.59 ± 0.17 vs. 0.91 ± 0.35 mV, p = 0.019). The optimal cutoff value of synV7 QRS amplitude was 0.61 mV, with a sensitivity of 80.0% and a specificity of 83.7% for predicting an OS. Univariate logistic analysis showed that a synV7 QRS amplitude of <0.61 mV was only associated with an OS (odd ratio, 20.0; 95% confidence interval, 1.66-241.72; p = 0.018).</p><p><strong>Conclusions: </strong>In patients with S-ICDs, an OS was not a rare complication during long-term follow-up. A low synV7 QRS amplitude was associated with a high OS incidence.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"1565-1573"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized Controlled Trial Comparing Training of Transseptal Puncture With or Without Intracardiac Echocardiography.","authors":"Qi Guo, Caihua Sang, Yiwei Lai, Mingyang Gao, Xueyuan Guo, Wenli Dai, Songnan Li, Nian Liu, Song Zuo, Deyong Long, Jianzeng Dong, Changsheng Ma","doi":"10.1111/pace.15081","DOIUrl":"10.1111/pace.15081","url":null,"abstract":"<p><strong>Background: </strong>Intracardiac echocardiography (ICE) has been widely used in the catheter ablation of atrial fibrillation (AF). However, the value of ICE in the training of transseptal puncture (TSP) is unclear.</p><p><strong>Methods: </strong>ICE-Training Study was a single-center, parallel-group, unmasked, randomized controlled trial registered in ChineseClinicalTrials.gov. Participants were randomly assigned (1:1) to different groups (1) the ICE simulator training group (ICE-ST), in which TSP was trained and performed under the guidance of both ICE and x-ray; and (2) the conventional simulator training group (Con-ST), in which TSP was trained and performed only under the guidance of x-ray. The trainees need to undergo the training stage and the evaluation stage.</p><p><strong>Results: </strong>From October 2022 to December 2022, 18 consecutive fellows (age 32.4 ± 4.4 years, 12 males) without experience of TSP were included. The training period (16.9 ± 6.6 vs. 29.6 ± 8.7 times, p = 0.003) and the fluoroscopy time (120.3 ± 25.3 vs. 189.3 ± 40.2 s, p < 0.001) of the ICE-ST group was significantly shorter than that of the Con-ST group. No significant difference was found in the comprehensive performance of TSP in the ICE-ST group (composite score 96.7 ± 5.7) and the Con-ST group (composite score 95.9 ± 6.3, p = 0.62), but the selection of TSP sites in the ICE-ST group was commonly better than that in the Con-ST group.</p><p><strong>Conclusions: </strong>ICE could improve the efficiency of TSP training and optimize the site of TSP to facilitate catheter manipulation in the ablation.</p><p><strong>Trial registration: </strong>ChineseClinicalTrials.gov identifier: ChiCTR2200058377.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"1670-1678"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left-bundle branch optimized CRT implantation in a patient with persistent left superior vena cava.","authors":"Enes Elvin Gul, Jamshid Sodikov, Ahmet Lutfu Sertdemir, Akmal Yakubov","doi":"10.1111/pace.15068","DOIUrl":"10.1111/pace.15068","url":null,"abstract":"<p><p>Persistent left superior vena cava (PLSVC) is one of the anatomical variations, which can make device implantation more challenging and lead to incorrect lead placement, dislodgement, and procedure failure. Conduction system pacing (CSP) can be an alternative to traditional CRT implantation. Herein, we describe a brief case report of successful LBBAP-optimized CRT (LOT-CRT) via an innominate vein in a patient with PLSVC.</p>","PeriodicalId":54653,"journal":{"name":"Pace-Pacing and Clinical Electrophysiology","volume":" ","pages":"1627-1631"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}