Arrhythmias & electrophysiologyResearch article
Paced QRS morphology and lead location in left bundle branch area pacing assessed by photon-counting cardiac computed tomography
- retrospectively analyzed
- contrast-enhanced photon-counting computed tomography (PC-CT)
Authors' conclusion
A lead-tip to LV distance ≤3.2 mm predicted LBB capture. An initial q wave in lead V6 may serve as a marker of lead positioning. V1RWPT was partially influenced by the lead-tip to RV.
Study context
- Population
- Patients who underwent contrast-enhanced photon-counting CT after left bundle branch area pacing (LBBAP) implantationLBBP 9 · LVSP 9 · DSP 2
- Participants
- 20 patients
- Comparison
- Lead-tip location by PC-CT across LBBP, LVSP and DSP groups
- LBBPn = 9
- LVSPn = 9
- DSPn = 2
Main finding
As reported in the abstract
Lead-tip to LV distance
- Significantly shorter in the LBBP group than in the other groups
- P < 0.01
Further findings
| Outcome | Values |
|---|---|
| Initial q wave in lead V6 | lead-tip to LV ≤3.2 mm 54.5% · lead-tip to LV >3.2 mm 0% |
| Septal thickness: pre-procedural echocardiography vs at penetration site | Echocardiographic septal thickness 10.0 ± 1.9 mm · Septal thickness at penetration site 12.5 ± 3.8 mm |
- Septal thickness: pre-procedural echocardiography vs at penetration site — Echocardiography significantly underestimated septal thickness at the penetration site
- P < .01
- Initial q wave in lead V6: P < .01
ROC analysis of lead-tip to LV for LBB capture
- Optimal cutoff
- 3.2 mm
- Area under the curve
- 0.91
- Sensitivity
- 100%
- Specificity
- 81.8%
Correlation of V1 R-wave peak time (V1RWPT) with lead-tip to right ventricular (RV)
- r
- 0.636
- P
- P < 0.01
Original publication
Paced QRS morphology and lead location in left bundle branch area pacing assessed by photon-counting cardiac computed tomography. Heart Rhythm. Published 2 April 2026. doi:10.1016/j.hrthm.2026.03.1945
Summarised from the published abstract; every number is checked against it