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Premature beat of selective left bundle branch: a novel marker for reaching and capturing the left bundle branch

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Abstract

Background

It was recently shown that template beats and fixation beats of the premature ventricular contractions (PVCs) were generated during lead deployment. These could be exploited to guide the left bundle branch (LBB) pacing (LBBP) procedure. However, lack of a revolving connector that can continuously record and pace during lead rotations has been a limitation when using the traditional implant technique. Here, we report ten cases in which a revolving connector was used and showed that the premature beats of selective left bundle branch (SLBB-PBs) were generated as the lead was reached and the electrical stimulus selectively captured the LBB.

Methods and results

Ten patients who underwent the transseptal placement of the pacing lead using a revolving connector were included in the study. We aimed to examine whether the SLBB-PB was a marker of LBB capture during LBBP and the clinical significance of SLBB-PB. LBBP was performed and data of these cases were analyzed to show the characteristics of the electrocardiogram and the intracardiac electrogram of SLBB-PBs.

Conclusions

This is the first case series on SLBB-PBs in LBBP. The presence of SLBB-PBs suggested that the LBB was reached and selectively captured and possibly increased the safety of lead implantation.

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Funding

This work was supported by the Zhejiang Provincial Public Service and Application Research Foundation, China [grant number LGF22H020009] and the Ningbo Health Branding Subject Fund [grant number PPXK2018-01].

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Authors and Affiliations

  1. Department of Cardiology, Hwa Mei Hospital, University of Chinese Academy of Sciences, 41 Xibei Street, Ningbo, 315010, Zhejiang, China

    Jiabo Shen, Longfu Jiang, Hao Wu, Xiaojie Cai & Shanshan Zhuo

  2. Department of Biology, Integrated Science Center, College of William and Mary, Williamsburg, VA, USA

    Fei Jiang

  3. Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China

    Lifang Pan

Authors
  1. Jiabo Shen
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  2. Longfu Jiang
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  3. Fei Jiang
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  4. Hao Wu
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  5. Xiaojie Cai
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  6. Shanshan Zhuo
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  7. Lifang Pan
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Corresponding author

Correspondence to Longfu Jiang.

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Ethical approval

This study was approved by the Ethics Committee of Hwa Mei Hospital and was conducted according to the principles of the Declaration of Helsinki.

Conflict of interest

The corresponding author owns the patent for John Jiang’s connecting cable. The other author declares no conflict of interest.

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Shen, J., Jiang, L., Jiang, F. et al. Premature beat of selective left bundle branch: a novel marker for reaching and capturing the left bundle branch. J Interv Card Electrophysiol 66, 865–872 (2023). https://doi.org/10.1007/s10840-022-01203-2

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  • DOI: https://doi.org/10.1007/s10840-022-01203-2

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