Arrhythmias & electrophysiologyCohort study
Conduction-guided intervention: A first-in-human study of computed tomography angiography-guided targeting of proximal conduction system structures
- first-in-human prospective study
- consecutive patients
Authors' conclusion
CTA-guided conduction system mapping was feasible and enabled intentional targeting of proximal conduction structures in most patients. Integration of patient-specific anatomical information may complement conventional fluoroscopic and electrophysiological guidance during CSP implantation.
Study context
- Population
- Patients undergoing conduction system pacing (CSP)consecutive patients undergoing CSP enrolled
- Participants
- 40 patients
Main finding
As reported in the abstract
Conduction-guided intervention (CGI)
95%
38/40 of 40
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Distal His pacing initially achieved according to predefined procedural criteria | Conduction-guided intervention (CGI) 65% |
- Distal His pacing initially achieved according to predefined procedural criteria — Transition to proximal left bundle branch (LBB) trunk pacing required because of inadequate QRS correction and/or unfavorable pacing thresholds (patients)
- 12
Proximal conduction system anatomy on computed tomography angiography (CTA)
- Substantial inter-individual variability, with marked differences in distances and trajectories along the AVN-His axis between patients
Final adjudicated pacing sites and clinical success (proximal conduction system capture with QRS correction at working output)
- Distal His pacing
- 14 patients (35%)
- Proximal LBB trunk pacing
- 22 patients (55%)
- Proximal conduction system pacing (clinical success)
- 36/40 patients (clinical success 90%)
Original publication
Summarised from the published abstract; every number is checked against it