Pacing system analyzers to guide conduction system pacing implantation procedures : A comparison study of intracardiac and surface signals with an electrophysiology recording system
Jiménez-López, Jesús (Hospital del Mar (Barcelona, Catalunya))
González-Matos, Carlos Eduardo (Universitat Autònoma de Barcelona. Departament de Medicina)
Rodríguez-Queraltó, Oriol (Hospital del Mar (Barcelona, Catalunya))
Francisco Pascual, Jaume (Vall d'Hebron Institut de Recerca (VHIR))
Lal-Trehan Estrada, Nisha (Vall d'Hebron Institut de Recerca (VHIR))
Martín-Sánchez, Gabriel (Hospital Universitari Joan XXIII de Tarragona)
Cabrera-Gómez, Sandra (Hospital Universitari Joan XXIII de Tarragona)
Molina Lerma, Manuel (Hospital Universitario Virgen de las Nieves (Granada))
Casteigt, Benjamín (Hospital del Mar (Barcelona, Catalunya))
Mercè-Klein, Jordi (Institut d'Investigació Biomèdica de Bellvitge)
Rodríguez-García, Marcos A. (Institut d'Investigació Biomèdica de Bellvitge)
Benito-Martín, Eva (Hospital Universitari de Girona Doctor Josep Trueta)
Conejos-Montenegro, Javier (Hospital Universitari de Girona Doctor Josep Trueta)
Rodríguez Garrido, Jorge Luis (Complejo Hospitalario Universitario de A Coruña)
Elices Teja, Juliana (Hospital Universitario Lucus Augusti (Lugo))
Cosialls Guillen, Pau (Hospital del Mar (Barcelona, Catalunya))
Toledo Silva, Aitor (Hospital del Mar (Barcelona, Catalunya))
Reitmaier, Carolina (Hospital del Mar (Barcelona, Catalunya))
Vallès Gras, Ermengol (Hospital del Mar (Barcelona, Catalunya))

Data:	2025
Resum:	Background: Left bundle branch area pacing (LBBAP) needs confirmation of left conduction system capture assessed by testing of different electrical parameters. Guidelines recommend the use of an electrophysiology recording system (EP-RS) to guide conduction system pacing procedures. However, some experienced centers perform LBBAP procedures without an EP-RS. Objective: We aimed to assess whether LBBAP criteria can be measured by the signals provided by the pacing system analyzers (PSAs) as a surrogate for the EP-RS to simplify and universalize the technique. Methods: This was an observational, prospective, multicenter study assessing the current LBBAP criteria using the PSA compared with the EP-RS during conduction system pacing procedures. Results: A consecutive 108 patients were included. Baseline QRS duration was 130 ± 29 ms in the EP-RS vs 128 ± 29 ms in the PSA (P =. 7). An initial W morphology in V was noted in 88% of patients with the EP-RS vs 86% of patients with the PSA (P =. 7) during unipolar pacing. The QRS duration (122 ± 17 ms vs 123 ± 19 ms; P =. 7), the R-wave peak time interval in V (80 ± 13 ms vs 79 ± 14 ms (P =. 9), and the V-V interpeak interval (39 ± 16 ms vs 38 ± 17 ms (P =. 7) were superimposable in the EP-RS compared with the PSA. Pearson coefficients for the last 2 criteria were 0. 85 (P <. 0001) and 0. 94 (P <. 0001), respectively. According to the current criteria, 91. 5% of patients received a successful LBBAP implant using the EP-RS. Based on the PSA measurements, 96. 6% of these patients met LBBAP criteria. Conclusion: Criteria for LBBAP can be assessed by PSAs with high accuracy. These results provide the basis for the usefulness of the PSA to guide LBBAP procedures.
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Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Conduction system pacing ; Left bundle branch area pacing ; Electrophysiological recording system ; Pacing system analyzer ; Surface Electrocardiogram leads
Publicat a:	Heart Rhythm, 2025 , ISSN 1556-3871

DOI: 10.1016/j.hrthm.2024.12.030

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