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Feasibility and safety of zero‐fluoroscopy left bundle branch pacing: An initial experience

INTRODUCTION: Left bundle branch pacing (LBBP) has emerged in recent years as a new pacing modality, providing patients with a narrower paced QRS than conventional pacing and stable pacing parameters. At the same time, there is a growing concern about the use of fluoroscopy in pacemaker implantation...

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Autores principales: Ramos‐Maqueda, Javier, Melero‐Polo, Jorge, Montilla‐Padilla, Isabel, Ruiz‐Arroyo, José Ramón, Cabrera‐Ramos, Mercedes
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10107534/
https://www.ncbi.nlm.nih.gov/pubmed/36448425
http://dx.doi.org/10.1111/jce.15765
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author Ramos‐Maqueda, Javier
Melero‐Polo, Jorge
Montilla‐Padilla, Isabel
Ruiz‐Arroyo, José Ramón
Cabrera‐Ramos, Mercedes
author_facet Ramos‐Maqueda, Javier
Melero‐Polo, Jorge
Montilla‐Padilla, Isabel
Ruiz‐Arroyo, José Ramón
Cabrera‐Ramos, Mercedes
author_sort Ramos‐Maqueda, Javier
collection PubMed
description INTRODUCTION: Left bundle branch pacing (LBBP) has emerged in recent years as a new pacing modality, providing patients with a narrower paced QRS than conventional pacing and stable pacing parameters. At the same time, there is a growing concern about the use of fluoroscopy in pacemaker implantations, given its harmful effects on both patients and operators. However, there are no prior experiences of zero‐fluoroscopy in LBBP procedure. METHODS: We conducted an observational prospective study recruiting consecutive patients that underwent zero‐fluoroscopy LBBP pacemaker implantation. A 6‐month follow‐up visit was programmed for every patient. The main goal of our study was to assess the efficacy, feasibility, and safety of the procedure. RESULTS: From January 2021 to February 2022, we included 10 patients, 8 males. The average age was 63 ± 4 years. The procedure was successful in all patients. We observed a significant reduction in paced QRS width compared with basal QRS width (149 ± 31.9 vs. 116 ± 15.6 ms, p = .02). All device parameters remained stable at 6‐month follow‐up: no significant differences in mean impedance (700.5 ± 136.4 vs. 494 ± 72.7 Ohm, p = .09), capture threshold (0.67 ± 0.2 vs. 0.83 ± 0.2 V @ 0.4 ms, p = .27) or endocardial V‐wave amplitude (10.6 ± 5.2 vs. 13.9 ± 6.3 mV, p = .19). No complications were reported in any case. CONCLUSION: Zero‐fluoroscopy LBBP is feasible and safe, and it may be considered in cases where radiation exposure is contraindicated or especially undesirable. Future randomized clinical trials are needed for the widespread use of this new technique.
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spelling pubmed-101075342023-04-18 Feasibility and safety of zero‐fluoroscopy left bundle branch pacing: An initial experience Ramos‐Maqueda, Javier Melero‐Polo, Jorge Montilla‐Padilla, Isabel Ruiz‐Arroyo, José Ramón Cabrera‐Ramos, Mercedes J Cardiovasc Electrophysiol Original Articles INTRODUCTION: Left bundle branch pacing (LBBP) has emerged in recent years as a new pacing modality, providing patients with a narrower paced QRS than conventional pacing and stable pacing parameters. At the same time, there is a growing concern about the use of fluoroscopy in pacemaker implantations, given its harmful effects on both patients and operators. However, there are no prior experiences of zero‐fluoroscopy in LBBP procedure. METHODS: We conducted an observational prospective study recruiting consecutive patients that underwent zero‐fluoroscopy LBBP pacemaker implantation. A 6‐month follow‐up visit was programmed for every patient. The main goal of our study was to assess the efficacy, feasibility, and safety of the procedure. RESULTS: From January 2021 to February 2022, we included 10 patients, 8 males. The average age was 63 ± 4 years. The procedure was successful in all patients. We observed a significant reduction in paced QRS width compared with basal QRS width (149 ± 31.9 vs. 116 ± 15.6 ms, p = .02). All device parameters remained stable at 6‐month follow‐up: no significant differences in mean impedance (700.5 ± 136.4 vs. 494 ± 72.7 Ohm, p = .09), capture threshold (0.67 ± 0.2 vs. 0.83 ± 0.2 V @ 0.4 ms, p = .27) or endocardial V‐wave amplitude (10.6 ± 5.2 vs. 13.9 ± 6.3 mV, p = .19). No complications were reported in any case. CONCLUSION: Zero‐fluoroscopy LBBP is feasible and safe, and it may be considered in cases where radiation exposure is contraindicated or especially undesirable. Future randomized clinical trials are needed for the widespread use of this new technique. John Wiley and Sons Inc. 2022-12-15 2023-02 /pmc/articles/PMC10107534/ /pubmed/36448425 http://dx.doi.org/10.1111/jce.15765 Text en © 2022 The Authors. Journal of Cardiovascular Electrophysiology published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Ramos‐Maqueda, Javier
Melero‐Polo, Jorge
Montilla‐Padilla, Isabel
Ruiz‐Arroyo, José Ramón
Cabrera‐Ramos, Mercedes
Feasibility and safety of zero‐fluoroscopy left bundle branch pacing: An initial experience
title Feasibility and safety of zero‐fluoroscopy left bundle branch pacing: An initial experience
title_full Feasibility and safety of zero‐fluoroscopy left bundle branch pacing: An initial experience
title_fullStr Feasibility and safety of zero‐fluoroscopy left bundle branch pacing: An initial experience
title_full_unstemmed Feasibility and safety of zero‐fluoroscopy left bundle branch pacing: An initial experience
title_short Feasibility and safety of zero‐fluoroscopy left bundle branch pacing: An initial experience
title_sort feasibility and safety of zero‐fluoroscopy left bundle branch pacing: an initial experience
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10107534/
https://www.ncbi.nlm.nih.gov/pubmed/36448425
http://dx.doi.org/10.1111/jce.15765
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