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Left bundle branch area pacing using stylet-driven pacing leads as compared to lumen-less leads
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  • Jan De Pooter,
  • Simon Calle,
  • Frank Timmermans,
  • Frédéric Van Heuverswyn
Jan De Pooter
University Hospital Ghent

Corresponding Author:[email protected]

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Simon Calle
University Hospital Ghent Heart Center
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Frank Timmermans
Univeristy of Ghent
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Frédéric Van Heuverswyn
Ghent University Hospital
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Introduction Left bundle branch area pacing (LBBAP) aims to achieve physiological pacing by capturing the conduction system in the area of the left bundle branch. LBBAP has exclusively been performed using lumen-less pacing leads (LLL) with fixed helix design. This study explores the feasibility, safety and pacing characteristics of LBBAP using stylet-driven leads (SDL) with an extendable helix design. Methods Patients, in which LBBAP was attempted for bradycardia or heart failure pacing indications, were prospectively enrolled at the Ghent University Hospital. LBBAP was attempted with two different systems: 1/ LLL with fixed helix (SelectSecure 3830, Medtronic, Inc) delivered through a preshaped sheath (C315His Medtronic) and 2/ SDL with extendable helix (SoliaS60, Biotronik, SE & CO) delivered through a new delivery sheath (Selectra 3D, Biotronik). Results The study enrolled 50 patients (mean age 7014 years, 44% female). LBBAP with SDL was successful in 20/23 (87%) patients compared to 24/27 (89%) of patients in the LLL group (p=0.834). Screw attempts, screw implant depth, procedural and fluoroscopy times were comparable among both groups. Acute LBBAP thresholds were low and comparable between SDL and LLL (0.50.15V versus 0.40.17V, p=0.251). Pacing thresholds remained low at 32.1 months of follow up in both groups and no lead revisions were necessary. Post procedural echocardiography revealed a septal coronary artery fistula in one patient with SDL LBBAP. Conclusion LBBAP using stylet-driven pacing leads is feasible and yields comparable implant success to LBBAP with lumen-less pacing leads. LBBAP thresholds are low and comparable with both types of leads.
20 Aug 2020Submitted to Journal of Cardiovascular Electrophysiology
24 Aug 2020Submission Checks Completed
24 Aug 2020Assigned to Editor
24 Aug 2020Reviewer(s) Assigned
11 Sep 2020Review(s) Completed, Editorial Evaluation Pending
13 Sep 2020Editorial Decision: Revise Minor
01 Oct 20201st Revision Received
01 Oct 2020Submission Checks Completed
01 Oct 2020Assigned to Editor
01 Oct 2020Reviewer(s) Assigned
15 Oct 2020Review(s) Completed, Editorial Evaluation Pending
16 Oct 2020Editorial Decision: Revise Minor
20 Oct 20202nd Revision Received
21 Oct 2020Assigned to Editor
21 Oct 2020Submission Checks Completed
21 Oct 2020Reviewer(s) Assigned
05 Nov 2020Review(s) Completed, Editorial Evaluation Pending
05 Nov 2020Editorial Decision: Revise Minor
06 Nov 20203rd Revision Received
09 Nov 2020Assigned to Editor
09 Nov 2020Submission Checks Completed
09 Nov 2020Reviewer(s) Assigned
22 Nov 2020Review(s) Completed, Editorial Evaluation Pending
23 Nov 2020Editorial Decision: Revise Minor
23 Nov 20204th Revision Received
26 Nov 2020Submission Checks Completed
26 Nov 2020Assigned to Editor
26 Nov 2020Reviewer(s) Assigned
13 Dec 2020Review(s) Completed, Editorial Evaluation Pending
14 Dec 2020Editorial Decision: Accept