Conduction system pacing using intracardiac echocardiography guidance - a case report
Conduction system pacing (CSP) is a pacing technique involving the implantation of permanent pacing leads at different sites along the cardiac conduction system and includes His bundle pacing (HBP) and left bundle branch area pacing (LBBAP). Intracardiac echocardiography (ICE) might facilitate the implantation of the permanent pacing lead in the left bundle branch (LBB) area of the interventricular septum. We report a case of an 83-year-old patient presenting with right bundle branch block (RBBB), left anterior fascicular block (LAFB), and dizzy spells during episodes of 2:1 atrioventricular (AV) block who underwent CSP with ICE guidance at our center. Apart from standard fl uoroscopic guidance and monitoring of intracardiac signals, ICE was also used to monitor lead advancement in the septum during the implantation. The landing zone and penetration depth of the pacing lead through the RV septum, mid-septum, and LBB area septum were easily visualized with ICE. Selective LBBAP demonstrated by the accepted ECG and electrogram criteria was achieved. Automated strain rate protocol with speckle tracking was used to demonstrate preserved left ventricular (LV) synchrony following the implantation. The use of ICE to guide LBBAP implantation can be used to monitor lead penetration in the septum, potentially improving the safety and effi cacy of this promising pacing modality..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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| Enthalten in: |
Българска кардиология - 29(2023), 4, Seite 89-96 |
| Sprache: |
Bulgarisch ; Englisch |
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| Beteiligte Personen: |
E. Martinov [VerfasserIn] |
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| Links: |
doi.org [kostenfrei] |
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| Themen: |
Diseases of the circulatory (Cardiovascular) system |
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| doi: |
10.3897/bgcardio.29.e116261 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
DOAJ097822701 |
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| 520 | |a Conduction system pacing (CSP) is a pacing technique involving the implantation of permanent pacing leads at different sites along the cardiac conduction system and includes His bundle pacing (HBP) and left bundle branch area pacing (LBBAP). Intracardiac echocardiography (ICE) might facilitate the implantation of the permanent pacing lead in the left bundle branch (LBB) area of the interventricular septum. We report a case of an 83-year-old patient presenting with right bundle branch block (RBBB), left anterior fascicular block (LAFB), and dizzy spells during episodes of 2:1 atrioventricular (AV) block who underwent CSP with ICE guidance at our center. Apart from standard fl uoroscopic guidance and monitoring of intracardiac signals, ICE was also used to monitor lead advancement in the septum during the implantation. The landing zone and penetration depth of the pacing lead through the RV septum, mid-septum, and LBB area septum were easily visualized with ICE. Selective LBBAP demonstrated by the accepted ECG and electrogram criteria was achieved. Automated strain rate protocol with speckle tracking was used to demonstrate preserved left ventricular (LV) synchrony following the implantation. The use of ICE to guide LBBAP implantation can be used to monitor lead penetration in the septum, potentially improving the safety and effi cacy of this promising pacing modality. | ||
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