Arrhythmias & electrophysiology
Innovative approach to conduction system pacing: Real-time electrocardiographic (ECG) imaging guidance for precise left bundle branch area pacemaker lead placement
Authors' conclusion
ECGI can bring significant value to conduction system device implantation. ECGI allows direct visualization of every procedural step, and its values confirm correct lead positioning and physiological ventricular activation.
Study context
- Population
- Patients undergoing left bundle branch area pacing (LBBAP) device implantation under real-time ECG imaging (electrocardiographic imaging (ECGI)) guidance
- Participants
- 10 consecutive patients
- Outcome
- LBBAP implantation success and ECGI assessment of lead placement
Methodological detailssingle-centre, consecutive patients
- Single-centre
- Consecutive patients
Main finding
As reported in the abstract
- LBBAP implantation successful in all patients
- All procedures performed with only 1 screwing attempt
- ECGI a fast and visual way to assess interventricular activation at every stage of lead implantation
- Inferoposterior sheath positions associated with long total ventricular activation time on ECGI and higher interventricular dyssynchrony than anterosuperior septal positions
- Screwing depth mostly characterised by reduction of total and LV activation time on ECGI during screwing
Observational data: associations, not effects.
Original publication
Innovative approach to conduction system pacing: Real-time ECG imaging guidance for precise left bundle branch area pacemaker lead placement. Heart Rhythm. Published 3 December 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →