Abstract 13086: Mid-Term Feasibility of Left Bundle Branch Area Pacing With Standard Stylet-Driven Pacing Leads and Predictors of Success: A Multicenter Center Experience

Abstract

Introduction: Conventional right ventricular apical pacing can cause electrical-mechanical dyssynchrony. For this reason, physiological pacing was considered and became the background for the development of his bundle pacing (HBP). Recently, left bundle branch area pacing (LBBAP), which overcomes the shortcomings of HBP, has been implemented. Hypothesis: Initially, LBBAP was achieved through a lumen-less lead, and it has been reported that LBBAP using a standard stylet-driven lead (SDL) is also available. The purpose of this study is to establish the feasibility and mid-term outcome of LBBAP using SDL, and to investigate the predictors of success. Methods: This study enrolled a total of 119 patients who underwent LBBAP from December 2020 to February 2022. LBBAP was performed with a 5.6Fr stylet-driven pacing lead with an extendable helix (Solia S60, Biotronik, SE & Co, KG). We analyzed the initial outcomes of the procedure, including the success rate and complications, and identified predictive factors that affect them. lead parameters were assessed in follow up. Results: Total success rate of lead implantation of LBBAP with conventional stylet-driven lead was 95.8% for entire period and showed increase in success rate as the number of procedures increased. In the multivariate analysis, The larger the RA size, the greater the number of trials (Estimates = 1.770 [1.10 - 2.44], p = <0.001) and the smaller the RV size, the greater the number of trials (Estimates = -0.923 [-1.64 - -0.21], p = 0.012). The mean thresholds at implant, 2 months, 6 months were 0.90 ± 0.80 V at 0.5 ms, 0.80 ± 0.16 V at 0.5 ms, and 0.87 ± 0.28 V at 0.5 ms respectively in total period. Conclusions: LBBAP with conventional stylet-driven lead is a feasible and safe pacing modality. It has a high success rate and fewer complications, satisfied and stable lead parameters in intermediate-term observations.