Figure 3: LBBAP using stylet-driven and lumen-less pacing leads
Fluoroscopic localization, twelve-lead electrocardiogram and intracardiac recordings from LBBAP lead are shown. Upper panel: Representative example of left bundle branch area pacing (LBBAP) using a stylet-driven lead (Solia S). Unipolar pacing yielded a narrow paced QRS morphology with typical Qr pattern in lead V1, short paced QRS duration (pQRSD) of 105ms and short interval form stimulus to peak left ventricular activation time (LVAT) of 72ms. Note the presence of left bundle branch potential (LBBp) on the intracardiac (IC) electrograms. Lower panel: Representative example of LBBAP using a lumen-less lead with fixed helix (SelectSecure 3830 lead, Medtronic). LBBAP at this position resulted in a narrow (84ms) paced QRS morphology with short stimulus to LVAT (51ms) and typical Qr pattern in lead V1. At this site a LBBp was noted.