Scholarlink

Introduction <p>Left bundle branch (LBB) pacing (LBBP) demonstrates clinical potential but faces challenges in confirming selective capture via dynamic electrogram (EGM) criteria.</p> Case report <p>A 69-year-old male with a complete atrioventricular block underwent LBBP implantation. Real-time EGM monitoring (high-pass/low-pass filters: 200/500 Hz) revealed an abrupt shortening of stimulus-to-V6 R-wave peak time (Sti-V6 RWPT) from 87 to 69 ms during lead deployment, indicating a transition from septal pacing to LBBP. Output reduction (1.6 V → 1.5 V/0.5 ms) eliminated myocardial excitation notches, yielding isoelectric EGMs confirming selective LBB capture. Further output reduction (1.4 V → 1.3 V/0.5 ms) prolonged Sti-V6 RWPT to 90 ms with an isoelectric interval, suggesting fascicular-level conduction delay.</p> Conclusion <p>This case report illustrates the electrophysiological features of a diseased conduction system via dynamic EGM analysis, despite technical limitations such as signal artifacts. While EGM morphological patterns assist in differentiating pacing modalities, further validation of these electrophysiological observations is necessary.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Electrogram transition patterns in left bundle branch pacing: a case report

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年5月30日

查看全文
  • Jiabo Shen,
  • Longfu Jiang,
  • Hao Wu,
  • Hengdong Li

摘要

Introduction

Left bundle branch (LBB) pacing (LBBP) demonstrates clinical potential but faces challenges in confirming selective capture via dynamic electrogram (EGM) criteria.

Case report

A 69-year-old male with a complete atrioventricular block underwent LBBP implantation. Real-time EGM monitoring (high-pass/low-pass filters: 200/500 Hz) revealed an abrupt shortening of stimulus-to-V6 R-wave peak time (Sti-V6 RWPT) from 87 to 69 ms during lead deployment, indicating a transition from septal pacing to LBBP. Output reduction (1.6 V → 1.5 V/0.5 ms) eliminated myocardial excitation notches, yielding isoelectric EGMs confirming selective LBB capture. Further output reduction (1.4 V → 1.3 V/0.5 ms) prolonged Sti-V6 RWPT to 90 ms with an isoelectric interval, suggesting fascicular-level conduction delay.

Conclusion

This case report illustrates the electrophysiological features of a diseased conduction system via dynamic EGM analysis, despite technical limitations such as signal artifacts. While EGM morphological patterns assist in differentiating pacing modalities, further validation of these electrophysiological observations is necessary.