Defining the distance between the His bundle and first septal perforator: implications for left bundle branch pacing.
J Interv Card Electrophysiol
; 66(5): 1113-1117, 2023 Aug.
Article
em En
| MEDLINE
| ID: mdl-36155878
ABSTRACT
BACKGROUND:
Left bundle branch pacing (LBBP) is a developing method of native conduction pacing, but cases of injury to the septal perforator arteries during implantation have been reported. Knowing the distance between the His bundle and the first septal perforator artery can help operators implant LBBP leads more safely.METHODS:
Using previously performed coronary CT angiography (CCTA) studies, the distance between the His bundle and the first septal perforator was measured.RESULTS:
A total of 50 CCTA studies were included. The mean distance from the His bundle to the first septal perforator (His-SP) along the line connecting the His bundle to the RV apex (His-RV apex) was 27.17 ± 7.7 mm with a range of 13.0 to 44.7 mm. The distance was greater than 2.0 cm in 84% of patients. To standardize this distance among patients with varying cardiac structures, the ratio between the His-SP distance and the His-RV Apex distance was also measured. The mean His-SPHis-RV Apex was 0.302 and the median was 0.298. Eighty-six percent of patients had a ratio of greater than 0.20.CONCLUSION:
Using this information, operators can aim to implant LBBP leads within 2.0 cm of the His bundle or 20% of the distance between the His bundle and the RV apex with minimal risk of causing vascular injury.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Bloqueio de Ramo
/
Fascículo Atrioventricular
Limite:
Humans
Idioma:
En
Revista:
J Interv Card Electrophysiol
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos