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- Title
Implantacja układów stymulujących rejon lewej odnogi pęczka Hisa z prawej strony --seria przypadków.
- Authors
Kowalska, W.; Mazurek, M.; Jędrzejczyk-Patej, E.; Szulik, M.; Suchodolski, A.; Lenarczyk, R.; Pluta, S.; Sokal, A.; Kowalski, O.; Kalarus, Z.
- Abstract
INTRODUCTION In recent years, conduction system pacing (CSP) has been gaining popularity as aphysiological alternative to right-ventricular pacing. Left bundle branch area pacing (LBBAP) is a new concept, which is defined as the capture of the subendocardial area on the left side of the interventricular septum. Compared to His bundle pacing (HBP) it has a wider target area, and the electrical parameters are more favorable. Currently, available delivery sheaths are designed for left-sided LBBAP implantation, making right-sided implantation challenging due to their specific curvature. As the demand for physiological stimulation is growing, the ride-sided LBBAP implantations will inevitably have to be performed. CASE SUMMARY Herein, we present a case series of four patients with right-sided LBBAP implantations. All of the described cases were device reimplantations after extractions due to cardiac-device related infective endocarditis. The pacing systems were successfully implanted in all cases using a standard LBBAP delivery sheath, with the right axillary vein as the vascular access. The procedures included implantation of three cardiac resynchronization devices (CRT-D) and one dual-chamber pacemaker. The median procedure time was 2 hours 15 minutes, the median fluoroscopy time was13 min 23 seconds. Only one post-procedural complication was observed - anemia requiring intravenous iron supplementation. No other short- or long-term complications were recognized. The ECG pattern and electrical parameters were stable during the median follow up time of 199 days (minimum 19, maximum 301 days). One of the patients died due to cardiovascular reasons 19 days post implantation. CONCLUSIONS Implantation of devices using the left bundle branch area pacing technique is possible from the right-sided approach, even in patients with extremely high risk of complications.
- Subjects
POLAND; THERAPEUTIC use of iron; REIMPLANTATION (Surgery); ANEMIA; IRON in the body; BUNDLE-branch block; PROSTHESIS-related infections; HEART assist devices; ENDOCARDITIS; TREATMENT effectiveness; CONFERENCES &; conventions; SURGICAL complications; INTRAVENOUS therapy; CARDIAC pacemakers; CARDIAC pacing; DIETARY supplements
- Publication
Polish Heart Journal / Kardiologia Polska, 2024, Vol 82, p70
- ISSN
0022-9032
- Publication type
Article