Current of injury amplitude during left bundle branch area pacing implantation: impact of filter settings, ventricular pacing, and lead type.
Europace
; 26(5)2024 May 02.
Article
in En
| MEDLINE
| ID: mdl-38753644
ABSTRACT
AIMS:
Monitoring current of injury (COI) during left bundle branch area pacing (LBBAP) implantation is useful to evaluate lead depth. Technical aspects for recording COI amplitude have not been well studied. Our aims were to evaluate the impact of high-pass filter settings on electrogram recordings during LBBAP implantation. METHODS ANDRESULTS:
Consecutive patients with successful LBBAP implantation had unipolar recordings of COI at final lead position at different high-pass filter settings (0.01-1â Hz) from the tip electrode during sensing and pacing, and from the ring electrode during sensing. Duration of saturation-induced signal loss was also measured at each filter setting. COI amplitudes were compared between lumenless and stylet-driven leads. A total of 156 patients (96 males, aged 81.4 ± 9.6 years) were included. Higher filter settings led to significantly lower COI amplitudes. In 50 patients with COI amplitude < 10â mV, the magnitude of the drop was on average 1-1.5â mV (and up to 4â mV) between 0.05 and 0.5â Hz, meaning that cut-offs may not be used interchangeably. Saturation-induced signal loss was on average 10â s at 0.05â Hz and only 2â s with 0.5â Hz. When pacing was interrupted, the sensed COI amplitude varied (either higher or lower) by up to 4â mV, implying that it is advisable to periodically interrupt pacing to evaluate the sensed COI when reaching levels of â¼10â mV. Lead type did not impact COI amplitude.CONCLUSION:
High-pass filters have a significant impact on electrogram characteristics at LBBAP implantation, with the 0.5â Hz settings having the most favourable profile.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cardiac Pacing, Artificial
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
En
Journal:
Europace
Journal subject:
CARDIOLOGIA
/
FISIOLOGIA
Year:
2024
Document type:
Article
Affiliation country:
Suiza
Country of publication:
Reino Unido