B-PO02-050 FIRST EXPERIENCE WITH A SINGLE CONDUIT MULTI-PRONG LEAD TO PROVIDE SEQUENTIAL PHYSIOLOGIC PACING IN AN ANIMAL MODEL

Abstract

Pacing of the AV conduction system remains challenging secondary to small pacing targets and technical considerations. To test the feasibility of a single lead for sequential multi-chamber pacing from Koch’s triangle in a swine model. A novel, multi-prong, single-conduit, pacing lead (MPL) (Fig) was implanted in a chronic survival experiment via a right jugular vein and custom-made sheaths in 5 animals and in an acute procedure simulation in 2. MPL was successfully implanted in all 7 animals (Table). Multiple pacing vectors (>50) were possible. Numerous combinations of atrial, conduction system and ventricular capture (4/7) were possible as were conduction system and ventricular capture (3/7). MPL remained fixed post-implant with the same pacing vectors at 3 months. 1. Dual-chamber (physiologic) pacing from a single location (Koch’s triangle) is feasible with an MPL. 2. Multiple pacing vector combinations are achievable acutely and chronically. 3. Deflectable sheath facilitates a quick and easy procedure with superb procedural characteristics.Tabled 1Acute and Chronic Pacing Parameters and Procedural CharacteristicsParameterAcuteChronicCapture threshold, (V) His bundle11.5 (2-22)11.9 (5-26)Right bundle branch (V)2.8 (0.5-8)9.0 (8-10)Atrial (V)8.3 (2-21)24.6 (14-38)Ventricular (V)2.9 (1-5)14.4 (2-35)P wave, mV0.5 (0.3-0.6)R wave, mV1.7 (1.4-2.0)Mapping time (MPL), min3.5 (2-5)NAImplant time, min2.5 (2-3)NA Open table in a new tab