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Related Experiment Video

Updated: Dec 11, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Permanent left bundle branch area pacing utilizing intracardiac echocardiogram.

Xiang-Fei Feng1, Peng-Pai Zhang2, Bo Liu2

  • 1Department of Cardiology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, 1665#, KongJiang Road, Shanghai, 200092, China. fengxiangfei@xinhuamed.com.cn.

BMC Cardiovascular Disorders
|August 20, 2020
PubMed
Summary

Left bundle branch area pacing (LBBAP) lead implantation in the right ventricle is challenging. A novel method using a nine-grid system and intracardiac echocardiography (ICE) successfully guided leads to the posteromedial basal septum in 86.7% of patients.

Keywords:
Intracardiac echocardiogramLeft bundle branchLocalizationNine-grid systemPacing

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Left bundle branch area pacing (LBBAP) is a feasible technique.
  • The optimal right ventricular (RV) implantation site for LBBAP remains unclear.
  • The posteromedial basal septum is proposed as a target RV implantation site.

Purpose of the Study:

  • To demonstrate the feasibility of a new method for guiding RV lead implantation for LBBAP.
  • To identify the posteromedial basal septum as a suitable implantation site.

Main Methods:

  • A nine-grid system on fluoroscopy combined with intracardiac echocardiogram (ICE) was used for RV lead positioning.
  • ICE was utilized for verification of the implantation site.
  • Fifteen patients were enrolled in the study.

Main Results:

  • The acute success rate for LBBAP lead implantation was 86.7% (13/15 patients).
  • ICE measurements confirmed implantation at the posteromedial basal septum.
  • Lead capture thresholds remained stable at 3-month follow-up in most patients.

Conclusions:

  • The posteromedial basal septum is a viable implantation site for LBBAP.
  • Intracardiac echocardiography (ICE) is a useful tool for guiding LBBAP lead implantation.
  • A combined approach using a nine-grid system and ICE is feasible and safe for LBBAP.