Initial Experience of Conduction System Pacing using Stylet Driven Lead
guided by a Deflectable Mapping catheter
BACKGROUND Conduction system pacing (CSP) in recent years is
being considered as the ideal pacing strategy. Lumen less leads (LLLs)
have been the predominantly used technology since its inception until
recently. We herein share the largest single-center experience of
Stylet-driven leads (SDLs) using deflectable mapping catheter, a recent
technology for conduction system pacing at both HB and LB areas, and
their medium-term outcomes. MATERIALS AND METHODS Patients with
standard pacing indications were enrolled between June 2021 and November
2022. The aim of this study was to evaluate safety and feasibility of
CSP using SDL guided by deflectable mapping delivery catheter by
analyzing implant tools, parameters during implant and follow- up.
RESULTS A total of 37 patients (mean age 67.16 + 9.89 years,
53.3% males, 31 pacemakers, 4 His-CRT-Ps and 2 dual chamber
Defibrillators, Mean follow up duration 210.7 + 25.1 days) were
enrolled. HBP was the default strategy. Procedural success was seen in
17/37 (45.9%) patients. Incidence of lead dislodgement was 17.6%.
LBBaP was tried in the rest (20/37). A septal curve was manually made in
3 patients. Procedural success was seen in all patients (3/3) in whom
septal curve was added and in 12/17 (70.5%) patients without it.
Compared to HBP, procedural parameters didn’t differ significantly for
LBBaP. Sensing and Pacing parameters remained stable on follow up.
CONCLUSION Use of SDL is adequate for both HB and LB areas.
Preeshaping the deflectable mapping catheter can help in achieving
better results and also lower the overall procedure time.