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Initial Experience of Conduction System Pacing using Stylet Driven Lead guided by a Deflectable Mapping catheter
  • +3
  • Anindya Ghosh,
  • Anand P. Yadav,
  • Mohamed Akram KA,
  • Angelin Marian Thomas,
  • Sangeetha Priya,
  • Ulhas M. Pandurangi
Anindya Ghosh
Madras Medical Mission Institute of Cardio Vascular Diseases
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Anand P. Yadav
Kurnool Medical College
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Mohamed Akram KA
Madras Medical Mission Institute of Cardio Vascular Diseases
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Angelin Marian Thomas
Madras Medical Mission Institute of Cardio Vascular Diseases
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Sangeetha Priya
Madras Medical Mission Institute of Cardio Vascular Diseases
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Ulhas M. Pandurangi
Madras Medical Mission Institute of Cardio Vascular Diseases

Corresponding Author:arrhythmiaheartfailureacademy@gmail.com

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Abstract

BACKGROUND Conduction system pacing (CSP) in recent years is being considered as the ideal pacing strategy. Lumen less leads (LLLs) have been the predominantly used technology since its inception until recently. We herein share the largest single-center experience of Stylet-driven leads (SDLs) using deflectable mapping catheter, a recent technology for conduction system pacing at both HB and LB areas, and their medium-term outcomes. MATERIALS AND METHODS Patients with standard pacing indications were enrolled between June 2021 and November 2022. The aim of this study was to evaluate safety and feasibility of CSP using SDL guided by deflectable mapping delivery catheter by analyzing implant tools, parameters during implant and follow- up. RESULTS A total of 37 patients (mean age 67.16 + 9.89 years, 53.3% males, 31 pacemakers, 4 His-CRT-Ps and 2 dual chamber Defibrillators, Mean follow up duration 210.7 + 25.1 days) were enrolled. HBP was the default strategy. Procedural success was seen in 17/37 (45.9%) patients. Incidence of lead dislodgement was 17.6%. LBBaP was tried in the rest (20/37). A septal curve was manually made in 3 patients. Procedural success was seen in all patients (3/3) in whom septal curve was added and in 12/17 (70.5%) patients without it. Compared to HBP, procedural parameters didn’t differ significantly for LBBaP. Sensing and Pacing parameters remained stable on follow up. CONCLUSION Use of SDL is adequate for both HB and LB areas. Preeshaping the deflectable mapping catheter can help in achieving better results and also lower the overall procedure time.