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Remote Magnetic Navigation for Accurate, Real-time Catheter Positioning and Ablation in Cardiac Electrophysiology Procedures
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Utility of a guiding catheter for conduction system pacing: An early multicenter experience

Jan De Pooter1, Alan Bulava2, Daniel Gras3

  • 1University Hospital Ghent, Ghent, Belgium.

Heart Rhythm O2
|February 5, 2024
PubMed

Insights

The new Selectra 3D catheter facilitates conduction system pacing (CSP) with high success rates and no early serious adverse device effects. This tool supports both His bundle pacing (HBP) and left bundle branch area pacing (LBBAP) for improved patient outcomes.

Area of Science:

  • Cardiology
  • Medical Devices
  • Electrophysiology

Background:

  • Conduction system pacing (CSP), encompassing His bundle pacing (HBP) and left bundle branch area pacing (LBBAP), presents a potentially superior alternative to traditional right ventricular pacing.
  • The efficacy and safety of CSP techniques are areas of ongoing research and clinical interest.

Purpose of the Study:

  • To evaluate the acute performance of the Biotronik Selectra 3D guiding catheter and Solia S lead for CSP implantations.
  • To assess the safety and feasibility of using this new system in a clinical setting.

Main Methods:

  • Prospective, international, nonrandomized study (BIO|MASTER.Selectra 3D).
  • Primary endpoint: freedom from catheter-related serious adverse device effects (SADEs) within 7 days of implantation.
  • Enrolled 157 patients, assessing implantation success, procedure time, and catheter handling.

Main Results:

  • CSP was successfully achieved in 147 patients (93.6%), with no SADEs within the first week.
  • Implantation success approached 99% when both HBP and LBBAP approaches were considered.
  • Mean procedure and fluoroscopy times were approximately 50 and 6 minutes, respectively, with most cases requiring only one catheter.
  • QRS duration narrowed in patients with bundle branch block and widened slightly in those without, indicating electrical effects of CSP.

Conclusions:

  • The Selectra 3D catheter is effective for HBP and LBBAP lead implantations.
  • High success rates (∼99%) were observed when both pacing strategies were considered, highlighting the value of procedural flexibility.
  • The catheter demonstrated positive handling characteristics and a favorable safety profile for CSP procedures.
Abstract

Keywords:
Cardiac pacingCatheter handling characteristicsConduction system pacingGuiding catheterHis bundleLeft bundle branch areaPacing lead implantation

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