Case report: Left bundle branch pacing guided by real-time monitoring of current of injury and electrocardiography
BackgroundLeft bundle branch (LBB) pacing (LBBP) has recently emerged as a physiological pacing mode. Current of injury (COI) can be used as the basis for electrode fixation position and detection of perforation. However, because the intermittent pacing method cannot monitor the changes in COI in re...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1025620/full |
| _version_ | 1811231348899184640 |
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| author | Jiabo Shen Longfu Jiang Hao Wu Hengdong Li Jinyan Zhong Lifang Pan |
| author_facet | Jiabo Shen Longfu Jiang Hao Wu Hengdong Li Jinyan Zhong Lifang Pan |
| author_sort | Jiabo Shen |
| collection | DOAJ |
| description | BackgroundLeft bundle branch (LBB) pacing (LBBP) has recently emerged as a physiological pacing mode. Current of injury (COI) can be used as the basis for electrode fixation position and detection of perforation. However, because the intermittent pacing method cannot monitor the changes in COI in real time, it cannot obtain information about the entire COI change process during implantation.Case summaryLeft bundle branch pacing was achieved for treatment of atrioventricular block in a 76-year-old female. Uninterrupted electrocardiogram and electrogram were recorded on an electrophysiology system. In contrast to the interrupted pacing method, this continuous pacing and recording technique enables real-time monitoring of the change in ventricular COI and the paced QRS complex as the lead advances into the interventricular septum. During the entire screw-in process, the COI amplitude increased and then decreased gradually after reaching the peak, followed by a small but significant, rather than dramatic, decrease.ConclusionThis case report aims to demonstrate the clinical significance of changes in COI and QRS morphology for LBBP using real-time electrocardiographic monitoring and filtered and unfiltered electrograms when the lead is deployed using a continuous pacing technique. The technique could be used to confirm LBB capture and avoid perforation. |
| first_indexed | 2024-04-12T10:43:40Z |
| format | Article |
| id | doaj.art-7f6dd49e735748318e6a1409c73fcca2 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-12T10:43:40Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-7f6dd49e735748318e6a1409c73fcca22022-12-22T03:36:31ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-11-01910.3389/fcvm.2022.10256201025620Case report: Left bundle branch pacing guided by real-time monitoring of current of injury and electrocardiographyJiabo Shen0Longfu Jiang1Hao Wu2Hengdong Li3Jinyan Zhong4Lifang Pan5Department of Cardiology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, ChinaDepartment of Cardiology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, ChinaDepartment of Cardiology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, ChinaDepartment of Cardiology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, ChinaDepartment of Cardiology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, ChinaDepartment of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, ChinaBackgroundLeft bundle branch (LBB) pacing (LBBP) has recently emerged as a physiological pacing mode. Current of injury (COI) can be used as the basis for electrode fixation position and detection of perforation. However, because the intermittent pacing method cannot monitor the changes in COI in real time, it cannot obtain information about the entire COI change process during implantation.Case summaryLeft bundle branch pacing was achieved for treatment of atrioventricular block in a 76-year-old female. Uninterrupted electrocardiogram and electrogram were recorded on an electrophysiology system. In contrast to the interrupted pacing method, this continuous pacing and recording technique enables real-time monitoring of the change in ventricular COI and the paced QRS complex as the lead advances into the interventricular septum. During the entire screw-in process, the COI amplitude increased and then decreased gradually after reaching the peak, followed by a small but significant, rather than dramatic, decrease.ConclusionThis case report aims to demonstrate the clinical significance of changes in COI and QRS morphology for LBBP using real-time electrocardiographic monitoring and filtered and unfiltered electrograms when the lead is deployed using a continuous pacing technique. The technique could be used to confirm LBB capture and avoid perforation.https://www.frontiersin.org/articles/10.3389/fcvm.2022.1025620/fullleft bundle branch pacingcurrent of injury (COI)electrocardiogram (ECG)intracardiac electrogramcontinuous recording technique |
| spellingShingle | Jiabo Shen Longfu Jiang Hao Wu Hengdong Li Jinyan Zhong Lifang Pan Case report: Left bundle branch pacing guided by real-time monitoring of current of injury and electrocardiography Frontiers in Cardiovascular Medicine left bundle branch pacing current of injury (COI) electrocardiogram (ECG) intracardiac electrogram continuous recording technique |
| title | Case report: Left bundle branch pacing guided by real-time monitoring of current of injury and electrocardiography |
| title_full | Case report: Left bundle branch pacing guided by real-time monitoring of current of injury and electrocardiography |
| title_fullStr | Case report: Left bundle branch pacing guided by real-time monitoring of current of injury and electrocardiography |
| title_full_unstemmed | Case report: Left bundle branch pacing guided by real-time monitoring of current of injury and electrocardiography |
| title_short | Case report: Left bundle branch pacing guided by real-time monitoring of current of injury and electrocardiography |
| title_sort | case report left bundle branch pacing guided by real time monitoring of current of injury and electrocardiography |
| topic | left bundle branch pacing current of injury (COI) electrocardiogram (ECG) intracardiac electrogram continuous recording technique |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1025620/full |
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