Left Bundle Branch Pacing Guided by Continuous Pacing Technique That Can Monitor Electrocardiograms and Electrograms in Real Time: A Technical Report

Left bundle branch pacing (LBBP) can achieve the physiological characteristics of pacing and provides a low and stable threshold compared with His bundle pacing.1 Huang W. Su L. Wu S. et al. A novel pacing strategy with low and stable output: pacing the left bundle branch immediately beyond the conduction block. Can J Cardiol. 2017; 33: 1736.e1 Abstract Full Text Full Text PDF Scopus (304) Google Scholar However, the inability to monitor paced QRS characteristics and impedance in real time to avoid perforation is a limitation of the practical application of the current interrupted pacing and screwing technique.2 Jastrzębski M. Kiełbasa G. Moskal P. et al. Fixation beats: a novel marker for reaching the left bundle branch area during deep septal lead implantation. Heart Rhythm. 2021; 18: 562-569 Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar ,3 Ponnusamy S.S. Vijayaraman P. Left bundle branch pacing guided by premature ventricular complexes during implant. Heart Rhythm Case Rep. 2020; 6: 850-853 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar This study aimed to illustrate a novel implantation technique based on continuous pacing and monitoring of electrocardiograms and electrograms during lead screwing. The technique has the potential to make the procedure more effective, safer, and quicker.