Left bundle branch area pacing guided by continuous uninterrupted monitoring of unipolar pacing characteristics

摘要

Abstract Introduction During left bundle branch area pacing (LBBAP) lead implantation, intermittent monitoring of unipolar pacing characteristics confirms LBB capture and can detect septal perforation. We aimed to demonstrate that continuous uninterrupted unipolar pacing from an inserted lead stylet (LS) is feasible and facilitates LBBAP implantation. Methods Thirty patients (mean age 76?±?14 years) were implanted with a stylet‐driven pacing lead (Biotronik Solia S60). In 10 patients (comparison‐group) conventional implantation with interrupted unipolar pacing was performed, with comparison of unipolar pacing characteristics between LS and connector‐pin (CP)‐pacing after each rotation step. In 20 patients (uninterrupted‐group) performance and safety of uninterrupted implantation during continuous pacing from the LS were evaluated. Results In the comparison group, LS and CP‐pacing impedances were highly correlated (R2?=?0.95, p?