Heart failure & cardiomyopathies
Stepwise application of ECG and electrogram-based criteria to ensure electrical resynchronization with left bundle branch pacing
Authors' conclusion
Stepwise application of ECG and electrogram criteria may provide an accurate assessment of electrical resynchronization with LBBP (Graphical abstract).
Study context
- Population
- Patients from the LEVEL-AT trial who received left bundle branch pacing (LBBP) and had electrocardiographic imaging (ECGI) at 45 days post-implant
- Participants
- 24 patients
- Comparison
- Stepwise ECG and electrogram-based criteria vs ECGI (gold standard) for electrical resynchronization with LBBP
- Outcome
- Accuracy of ECG- and electrogram-based criteria to predict electrical resynchronization with LBBP
- Follow-up
- 45 days post-implant
Methodological detailssubstudy of the LEVEL-AT trial, All patients fulfilled pre-screwing requisites: septal lead position in left-oblique projection and W paced morphology in V1
- Substudy of the LEVEL-AT trial
- All patients fulfilled pre-screwing requisites: septal lead position in left-oblique projection and W paced morphology in V1
Performance
As reported in the abstract
Prediction of electrical resynchronization with LBBP (gold standard: ECGI)
| Test or model | Sensitivity | Specificity | Accuracy |
|---|---|---|---|
| First step | 95% | 100% | 95.8% |
| Selective capture | 41% | 100% | — not stated in the abstract |
| Spike-R <80 ms | 46% | 100% | — not stated in the abstract |
Sensitivity
First step95%
Selective capture41%
Spike-R <80 ms46%
Specificity
First step100%
Selective capture100%
Spike-R <80 ms100%
Accuracy
First step95.8%
Selective capture— not stated in the abstract
Spike-R <80 ms— not stated in the abstract
— not stated in the abstract
- Second step (selective capture or spike-R <80 ms in non-selective capture) ensured accuracy
- 100%
Further findings
- Patients with electrical resynchronization on ECGI
- 22 (91.6%)
Original publication
Stepwise application of ECG and electrogram-based criteria to ensure electrical resynchronization with left bundle branch pacing. Europace. Published 9 June 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →