Preliminary results from a single-center registry of left bundle branch area pacing with the use of classic, non-dedicated electrodes, without the use of additional sheaths

FUNDING ACKNOWLEDGEMENTS: Type of funding sources: None. INTRODUCTION: In recent years, interest in left bundle branch area pacing (LBBAP) has been growing. The vast majority of reports concern procedures performed with the use of a dedicated set of equipment - a sheath and an electrode. PURPOSE: The aim of the study was to assess the possibility of using classical electrodes with active fixation, used for years, for stimulation of the left bundle branch, without the use of dedicated sheaths, which could allow the routine introduction of LBBAP in each patient without the need for preliminary qualification before the procedure. METHODS: These are preliminary results from a single-center, prospective registry of pacemaker, cardioverter-defibrillator and CRT-D implantation procedures from February to November 2022. Routine patients were enrolled in the registry. Abbott's Tendril STS electrodes were used for successful LBBAP. In all procedures only suitably shaped mandrills were used without any additional sheaths. RESULTS: 113 people (age 72.6 ± 13.8, 44 women) were included in the registry in the given period. Successful LBBAP was achieved in 107 (94,7%) patients, including 15 patients initially qualified for CRT-D. LBBAP was abandoned in 6 patients mainly due to problems with finding the optimal implantation site. The average time of mapping and effective fixation of the electrode was 21.7±14.7 minutes, x-ray time (whole procedure): 10:08±5:36 minutes, procedure time: 62,9±21,2 minutes, pacing threshold: 0.57±0.34V/0.4ms, sense: 9.5±4.5mV, resistance: 485±130 Ohms, RWPT: 74±12ms, interpeak (time between peak V6 and V1): 47±15ms. No important adverse events have been observed, nor problems with stimulation in follow-up. CONCLUSIONS: Preliminary results of LBBAP using classic electrodes without the use of dedicated equipment show results comparable to those achieved with dedicated electrodes and sheaths, which may facilitate the use of LBBAP as a routine stimulation method in most patients.