scholarly journals A Comparison of the Electrophysiological and Anatomic Characteristics of Pacing Different Branches of the Left Bundle Conduction System

2022 ◽  
Vol 8 ◽  
Author(s):  
Xi Liu ◽  
Min Gu ◽  
Hong-Xia Niu ◽  
Xuhua Chen ◽  
Chi Cai ◽  
...  
Keyword(s):  
Transition Zone ◽  
Tricuspid Valve ◽  
Conduction System ◽  
Visualization Technique ◽  
Main Trunk ◽  
Tricuspid Valve Annulus ◽  
Different Types ◽  
Qrs Duration ◽  
Valve Annulus ◽  
Lead Location

Introduction: Left bundle branch pacing (LBBP) is a rapidly growing conduction system pacing technique. However, little is known regarding the electrophysiological characteristics of different types of LBBP. We aimed to evaluate the electrophysiological characteristics and anatomic lead location with pacing different branches of the left bundle branch.Methods: Consecutive bradycardia patients with successful LBBP were enrolled and classified into groups according to the paced electrocardiogram and the lead location. Electrocardiogram, pacing properties, vectorcardiogram, and lead tip location were analyzed.Results: Ninety-one patients were enrolled, including 48 with the left bundle trunk pacing (LBTP) and 43 with the left bundle fascicular pacing (LBFP). The paced QRS duration in the LBTP group was significantly shorter than that in the LBFP group (108.1 ± 9.9 vs. 112.9 ± 11.2 ms, p = 0.03), with a more rightward QRS transition zone (p = 0.01). The paced QRS area in the LBTP group was similar to that during intrinsic rhythm (35.1 ± 15.8 vs. 34.7 ± 16.6 μVs, p = 0.98), whereas in the LBFP group, the paced QRS area was significantly larger compared to intrinsic rhythm (43.4 ± 15.8 vs. 35.7 ± 18.0 μVs, p = 0.01). The lead tip site for LBTP was located in a small fan-shaped area with the tricuspid valve annulus summit as the origin, whereas fascicular pacing sites were more likely in a larger and more distal area.Conclusions: Pacing the proximal left bundle main trunk produced better electrical synchrony compared with pacing the distal left bundle fascicles. A visualization technique can facilitate achieving LBTP.

Predicting Right Ventricular Failure After LVAD Implantation: Role of Tricuspid Valve Annulus Displacement

2020 ◽  
Vol 34 (5) ◽  
pp. 1204-1210 ◽  
Author(s):  
Andrej Alfirevic ◽  
Natalya Makarova ◽  
Marta Kelava ◽  
Shiva Sale ◽  
Edward Soltesz ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Tricuspid Valve ◽  
Right Ventricular Failure ◽  
Ventricular Failure ◽  
Tricuspid Valve Annulus ◽  
Valve Annulus

Successful Retrieval of a Knotted Pulmonary Artery Catheter Trapped in the Right Ventricle Using a Dormier Basket

1997 ◽  
Vol 42 (6) ◽  
pp. 184-184 ◽  
Author(s):  
S. Hood ◽  
H.M. McAlpine ◽  
J. A. H. Davidson
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Pulmonary Artery Catheter ◽  
Tricuspid Valve ◽  
Right Atrium ◽  
Femoral Vein ◽  
Tricuspid Valve Annulus ◽  
Valve Annulus ◽  
Successful Retrieval ◽  
The Right

We report the case of a 71 year old patient in whom a pulmonary artery catheter (Swan Ganz) formed a knot which was fixed within the right ventricle in the region of the tricuspid valve annulus. The catheter was successfully dislodged to the right atrium, subsequently snared by a dormier basket advanced from the right femoral vein and retrieved by localised cut down of the femoral vein.

scholarly journals Permanent His Bundle Pacing Implantation Facilitated by Visualization of the Tricuspid Valve Annulus

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
Min Gu ◽  
Hongxia Niu ◽  
Yiran Hu ◽  
Xi Liu ◽  
Nixiao Zhang ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Interventricular Septum ◽  
Implantation Technique ◽  
Control Group ◽  
His Bundle ◽  
His Bundle Pacing ◽  
Lead Placement ◽  
Tricuspid Valve Annulus ◽  
Significant Difference ◽  
Valve Annulus

Background: His bundle pacing (HBP) is the most physiological pacing modality. However, HBP has longer procedure times with frequent high capture thresholds, which likely contributes to the low adoption of this approach. The aim of this study is to compare HBP implantation with a novel imaging technique versus the standard implantation technique. Methods: This study included 50 patients with standard pacing indications randomized to HBP with visualization of the tricuspid valve annulus (N=25, the visualization group) or with the standard method (N=25, the control group). In the visualization group, the tricuspid valve annulus was imaged by contrast injection in the right ventricle during fluoroscopy. The site for HBP was identified in relationship to the tricuspid septal leaflet and interventricular septum. Results: Permanent HBP was successful in 92% in the visualization group and 88% in the control group. The fluoroscopic time for HBP lead placement was significantly shorter in the visualization group (7.1±3.3 minutes) compared with the control group (10.1±5.6 minutes, P =0.03). Total procedural and fluoroscopic times were also significantly shorter in the visualization group (91.0±15.7 and 9.6±3.8 minutes) than the control group (104.4±17.8 and 12.7±6.2 minutes, P =0.01 and 0.04, respectively). There was no significant difference in capture threshold between groups. In the visualization group, there was a quantitative association between the HBP site and the tricuspid valve annulus. Conclusions: The visualization technique shortens the procedural and fluoroscopic times for HBP implantation. Moreover, anatomic localization of HBP sites is strongly associated with physiological characteristics of pacing, which can help guide optimal lead placement. Registration: URL: https://www.chictr.org.cn/index.aspx . Unique identifier: ChiCTR2000029834.

Left bundle branch pacing from distal His‐bundle region by tricuspid valve annulus angiography

2019 ◽  
Vol 30 (11) ◽  
pp. 2550-2553 ◽  
Author(s):  
Yiran Hu ◽  
Min Gu ◽  
Wei Hua ◽  
Hui Li ◽  
Xi Liu ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
His Bundle ◽  
Tricuspid Valve Annulus ◽  
Valve Annulus
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