Initial experience with stylet-driven versus lumenless lead delivery systems for left bundle branch area pacing
Left bundle branch area pacing (LBBP) has emerged as an alternative method for conduction system pacing. While initial experience with delivery systems for stylet-driven and lumenless lead implantation for LBBP has been described, data comparing outcomes of stylet-driven versus lumenless lead implan...
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| Veröffentlicht in: | Journal of cardiovascular electrophysiology 2023-03, Vol.34 (3), p.710-717 |
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| container_title | Journal of cardiovascular electrophysiology |
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| creator | Braunstein, Eric D Kagan, Ruth D Olshan, David S Gabriels, James K Thomas, George Ip, James E Markowitz, Steven M Lerman, Bruce B Liu, Christopher F Cheung, Jim W |
| description | Left bundle branch area pacing (LBBP) has emerged as an alternative method for conduction system pacing. While initial experience with delivery systems for stylet-driven and lumenless lead implantation for LBBP has been described, data comparing outcomes of stylet-driven versus lumenless lead implantation for LBBP are limited. In this study, we compare success rates and outcomes of LBBP with stylet-driven versus lumenless lead delivery systems.
Eighty-three consecutive patients (mean age 74.1 ± 11.2 years; 56 [68%] male) undergoing attempted LBBP at a single institution were identified. Cases were grouped by lead delivery systems used: stylet-driven (n = 53) or lumenless (n = 30). Baseline characteristics and procedural findings were recorded and compared between the cohorts. Intermediate term follow-up data on ventricular lead parameters were also compared.
Baseline characteristics were similar between groups. Successful LBBP was achieved in 77% of patients, with similar success rates between groups (76% in stylet-driven, 80% in lumenless, p = 0.79), and rates of adjudicated LBB capture and other paced QRS parameters were also similar. Compared with the lumenless group, the stylet-driven group had significantly shorter procedure times (90 ± 4 vs. 112 ± 31 min, p = 0.004) and fluoroscopy times (10 ± 5 vs. 15 ± 6 min, p = 0.003). Ventricular lead parameters at follow-up were similar, and rates of procedural complications and need for lead revision were low in both groups.
Delivery systems for stylet-driven and for lumenless leads for LBBP have comparable acute success rates. Long-term follow-up of lead performance following use of the various delivery systems is warranted. |
| doi_str_mv | 10.1111/jce.15789 |
| format | Article |
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Eighty-three consecutive patients (mean age 74.1 ± 11.2 years; 56 [68%] male) undergoing attempted LBBP at a single institution were identified. Cases were grouped by lead delivery systems used: stylet-driven (n = 53) or lumenless (n = 30). Baseline characteristics and procedural findings were recorded and compared between the cohorts. Intermediate term follow-up data on ventricular lead parameters were also compared.
Baseline characteristics were similar between groups. Successful LBBP was achieved in 77% of patients, with similar success rates between groups (76% in stylet-driven, 80% in lumenless, p = 0.79), and rates of adjudicated LBB capture and other paced QRS parameters were also similar. Compared with the lumenless group, the stylet-driven group had significantly shorter procedure times (90 ± 4 vs. 112 ± 31 min, p = 0.004) and fluoroscopy times (10 ± 5 vs. 15 ± 6 min, p = 0.003). Ventricular lead parameters at follow-up were similar, and rates of procedural complications and need for lead revision were low in both groups.
Delivery systems for stylet-driven and for lumenless leads for LBBP have comparable acute success rates. Long-term follow-up of lead performance following use of the various delivery systems is warranted.</description><identifier>ISSN: 1045-3873</identifier><identifier>EISSN: 1540-8167</identifier><identifier>DOI: 10.1111/jce.15789</identifier><identifier>PMID: 36571159</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; Aged, 80 and over ; Bundle of His ; Cardiac Conduction System Disease ; Cardiac Pacing, Artificial - methods ; Electrocardiography - methods ; Female ; Fluoroscopy ; Heart Conduction System ; Humans ; Male ; Middle Aged ; Success ; Ventricle</subject><ispartof>Journal of cardiovascular electrophysiology, 2023-03, Vol.34 (3), p.710-717</ispartof><rights>2022 Wiley Periodicals LLC.</rights><rights>2023 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c313t-1192c1d29a7b8c4475664861316e5b09df71d93f3c99d0c12a10ab80e1fdc653</citedby><cites>FETCH-LOGICAL-c313t-1192c1d29a7b8c4475664861316e5b09df71d93f3c99d0c12a10ab80e1fdc653</cites><orcidid>0000-0001-6780-2903 ; 0000-0002-4574-9360 ; 0000-0002-3401-8933 ; 0000-0002-1095-6626 ; 0000-0002-3461-505X ; 0000-0002-9124-0952 ; 0000-0001-8852-4551 ; 0000-0001-5290-9089 ; 0000-0001-7158-8305</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,27933,27934</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36571159$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Braunstein, Eric D</creatorcontrib><creatorcontrib>Kagan, Ruth D</creatorcontrib><creatorcontrib>Olshan, David S</creatorcontrib><creatorcontrib>Gabriels, James K</creatorcontrib><creatorcontrib>Thomas, George</creatorcontrib><creatorcontrib>Ip, James E</creatorcontrib><creatorcontrib>Markowitz, Steven M</creatorcontrib><creatorcontrib>Lerman, Bruce B</creatorcontrib><creatorcontrib>Liu, Christopher F</creatorcontrib><creatorcontrib>Cheung, Jim W</creatorcontrib><title>Initial experience with stylet-driven versus lumenless lead delivery systems for left bundle branch area pacing</title><title>Journal of cardiovascular electrophysiology</title><addtitle>J Cardiovasc Electrophysiol</addtitle><description>Left bundle branch area pacing (LBBP) has emerged as an alternative method for conduction system pacing. While initial experience with delivery systems for stylet-driven and lumenless lead implantation for LBBP has been described, data comparing outcomes of stylet-driven versus lumenless lead implantation for LBBP are limited. In this study, we compare success rates and outcomes of LBBP with stylet-driven versus lumenless lead delivery systems.
Eighty-three consecutive patients (mean age 74.1 ± 11.2 years; 56 [68%] male) undergoing attempted LBBP at a single institution were identified. Cases were grouped by lead delivery systems used: stylet-driven (n = 53) or lumenless (n = 30). Baseline characteristics and procedural findings were recorded and compared between the cohorts. Intermediate term follow-up data on ventricular lead parameters were also compared.
Baseline characteristics were similar between groups. Successful LBBP was achieved in 77% of patients, with similar success rates between groups (76% in stylet-driven, 80% in lumenless, p = 0.79), and rates of adjudicated LBB capture and other paced QRS parameters were also similar. Compared with the lumenless group, the stylet-driven group had significantly shorter procedure times (90 ± 4 vs. 112 ± 31 min, p = 0.004) and fluoroscopy times (10 ± 5 vs. 15 ± 6 min, p = 0.003). Ventricular lead parameters at follow-up were similar, and rates of procedural complications and need for lead revision were low in both groups.
Delivery systems for stylet-driven and for lumenless leads for LBBP have comparable acute success rates. Long-term follow-up of lead performance following use of the various delivery systems is warranted.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Bundle of His</subject><subject>Cardiac Conduction System Disease</subject><subject>Cardiac Pacing, Artificial - methods</subject><subject>Electrocardiography - methods</subject><subject>Female</subject><subject>Fluoroscopy</subject><subject>Heart Conduction System</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Success</subject><subject>Ventricle</subject><issn>1045-3873</issn><issn>1540-8167</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkUtLxTAQhYMovhf-AQm40UU10zRJs5SLLxDcuC9pMtVe0vSatOr998bnwtnMgfNxGOYQcgTsHPJcLC2eg1C13iC7ICpW1CDVZtasEgWvFd8heyktGQMumdgmO1wKBSD0LhnvQj_1xlN8X2HsMVikb_30TNO09jgVLvavGOgrxjQn6ucBg8eUFRpHHfrsxjVN6zThkGg3xux0E23n4DzSNppgn6mJaOjK2D48HZCtzviEhz97nzxeXz0ubov7h5u7xeV9YTnwqQDQpQVXaqPa2laVElJWtQQOEkXLtOsUOM07brV2zEJpgJm2Zgids1LwfXL6HbuK48uMaWqGPln03gQc59SUStRcKFbxjJ78Q5fjHEM-LlO1KLnUvMzU2Tdl45hSxK5ZxX4wcd0Aaz5LaHIJzVcJmT3-SZzbAd0f-ft1_gHZSYK0</recordid><startdate>202303</startdate><enddate>202303</enddate><creator>Braunstein, Eric D</creator><creator>Kagan, Ruth D</creator><creator>Olshan, David S</creator><creator>Gabriels, James K</creator><creator>Thomas, George</creator><creator>Ip, James E</creator><creator>Markowitz, Steven M</creator><creator>Lerman, Bruce B</creator><creator>Liu, Christopher F</creator><creator>Cheung, Jim W</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6780-2903</orcidid><orcidid>https://orcid.org/0000-0002-4574-9360</orcidid><orcidid>https://orcid.org/0000-0002-3401-8933</orcidid><orcidid>https://orcid.org/0000-0002-1095-6626</orcidid><orcidid>https://orcid.org/0000-0002-3461-505X</orcidid><orcidid>https://orcid.org/0000-0002-9124-0952</orcidid><orcidid>https://orcid.org/0000-0001-8852-4551</orcidid><orcidid>https://orcid.org/0000-0001-5290-9089</orcidid><orcidid>https://orcid.org/0000-0001-7158-8305</orcidid></search><sort><creationdate>202303</creationdate><title>Initial experience with stylet-driven versus lumenless lead delivery systems for left bundle branch area pacing</title><author>Braunstein, Eric D ; Kagan, Ruth D ; Olshan, David S ; Gabriels, James K ; Thomas, George ; Ip, James E ; Markowitz, Steven M ; Lerman, Bruce B ; Liu, Christopher F ; Cheung, Jim W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c313t-1192c1d29a7b8c4475664861316e5b09df71d93f3c99d0c12a10ab80e1fdc653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Bundle of His</topic><topic>Cardiac Conduction System Disease</topic><topic>Cardiac Pacing, Artificial - methods</topic><topic>Electrocardiography - methods</topic><topic>Female</topic><topic>Fluoroscopy</topic><topic>Heart Conduction System</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Success</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Braunstein, Eric D</creatorcontrib><creatorcontrib>Kagan, Ruth D</creatorcontrib><creatorcontrib>Olshan, David S</creatorcontrib><creatorcontrib>Gabriels, James K</creatorcontrib><creatorcontrib>Thomas, George</creatorcontrib><creatorcontrib>Ip, James E</creatorcontrib><creatorcontrib>Markowitz, Steven M</creatorcontrib><creatorcontrib>Lerman, Bruce B</creatorcontrib><creatorcontrib>Liu, Christopher F</creatorcontrib><creatorcontrib>Cheung, Jim W</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiovascular electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Braunstein, Eric D</au><au>Kagan, Ruth D</au><au>Olshan, David S</au><au>Gabriels, James K</au><au>Thomas, George</au><au>Ip, James E</au><au>Markowitz, Steven M</au><au>Lerman, Bruce B</au><au>Liu, Christopher F</au><au>Cheung, Jim W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Initial experience with stylet-driven versus lumenless lead delivery systems for left bundle branch area pacing</atitle><jtitle>Journal of cardiovascular electrophysiology</jtitle><addtitle>J Cardiovasc Electrophysiol</addtitle><date>2023-03</date><risdate>2023</risdate><volume>34</volume><issue>3</issue><spage>710</spage><epage>717</epage><pages>710-717</pages><issn>1045-3873</issn><eissn>1540-8167</eissn><abstract>Left bundle branch area pacing (LBBP) has emerged as an alternative method for conduction system pacing. While initial experience with delivery systems for stylet-driven and lumenless lead implantation for LBBP has been described, data comparing outcomes of stylet-driven versus lumenless lead implantation for LBBP are limited. In this study, we compare success rates and outcomes of LBBP with stylet-driven versus lumenless lead delivery systems.
Eighty-three consecutive patients (mean age 74.1 ± 11.2 years; 56 [68%] male) undergoing attempted LBBP at a single institution were identified. Cases were grouped by lead delivery systems used: stylet-driven (n = 53) or lumenless (n = 30). Baseline characteristics and procedural findings were recorded and compared between the cohorts. Intermediate term follow-up data on ventricular lead parameters were also compared.
Baseline characteristics were similar between groups. Successful LBBP was achieved in 77% of patients, with similar success rates between groups (76% in stylet-driven, 80% in lumenless, p = 0.79), and rates of adjudicated LBB capture and other paced QRS parameters were also similar. Compared with the lumenless group, the stylet-driven group had significantly shorter procedure times (90 ± 4 vs. 112 ± 31 min, p = 0.004) and fluoroscopy times (10 ± 5 vs. 15 ± 6 min, p = 0.003). Ventricular lead parameters at follow-up were similar, and rates of procedural complications and need for lead revision were low in both groups.
Delivery systems for stylet-driven and for lumenless leads for LBBP have comparable acute success rates. Long-term follow-up of lead performance following use of the various delivery systems is warranted.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>36571159</pmid><doi>10.1111/jce.15789</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-6780-2903</orcidid><orcidid>https://orcid.org/0000-0002-4574-9360</orcidid><orcidid>https://orcid.org/0000-0002-3401-8933</orcidid><orcidid>https://orcid.org/0000-0002-1095-6626</orcidid><orcidid>https://orcid.org/0000-0002-3461-505X</orcidid><orcidid>https://orcid.org/0000-0002-9124-0952</orcidid><orcidid>https://orcid.org/0000-0001-8852-4551</orcidid><orcidid>https://orcid.org/0000-0001-5290-9089</orcidid><orcidid>https://orcid.org/0000-0001-7158-8305</orcidid></addata></record> |
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| ispartof | Journal of cardiovascular electrophysiology, 2023-03, Vol.34 (3), p.710-717 |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Aged Aged, 80 and over Bundle of His Cardiac Conduction System Disease Cardiac Pacing, Artificial - methods Electrocardiography - methods Female Fluoroscopy Heart Conduction System Humans Male Middle Aged Success Ventricle |
| title | Initial experience with stylet-driven versus lumenless lead delivery systems for left bundle branch area pacing |
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