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D-MP10-04 - Electrophysiological Characteristics And Clinical Values Of Left Bundle Branch Current Of Injury In Left Bundle Branch Pacing (ID 1388)

 L. Su: Nothing relevant to disclose.


Background: Left bundle branch pacing (LBBP) is emerging as a novel option for physiological ventricular pacing. The impact of COI at left bundle branch (LBB) has not been previously evaluated.
Objective: The aims of this study were to verify 1) the relationship between COI of LBB and conduction system capture, 2) stability of LBB lead.
Methods: Consecutive patients with QRS duration <120 ms referred for LBBP in whom LBB potentials were recorded were included from August 2018 to March 2019. We recorded LBB COI during LBBP and assessed its impact on the pacing parameters and complications during implantation and at short term follow-up.
Results: A total of 115 patients with an identifiable LBB potential at implant were included. LBB COI was confirmed in 77 (67.0%) of these patients. Three types of LBB COI were observed. LBB was captured in all patients at a pacing threshold < 1.5V/0.5ms in COI (+) patients, while present in only 29 patients without a LBB COI (-) (100% vs. 76.3%, P<0.001). There was no significant difference between COI (+) and COI (-) patients in LBB bundle capture threshold (0.64±0.24V/0.5ms vs. 0.74±0.26V/0.5ms). Selective LBBP was more common in COI (+) group than COI (-) group (54.5% vs. 0%, P<0.001). Pacing parameters were stable and no lead perforation or dislodgements were observed during follow-up.
Conclusion: LBB COI is commonly observed during LBBP in cases with an identifiable LBB potential and can be associated with a low LBB capture thresholds and demonstrable selective capture of the LBB acutely and during follow-up. A COI does not preclude safe and stable LBBP pacing.