Strength-duration curves for left bundle branch area pacing
Grzegorz Kiełbasa1, Marek Jastrzębski2, Agnieszka Bednarek1
1First Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University, Medical College, Krakow, Poland; First Department of Cardiology, Interventional Electrocardiology and Hypertension University Hospital in Krakow, Krakow, Poland.
Heart Rhythm
|May 17, 2024
Summary
Left bundle branch pacing (LBBP) and left ventricular septal pacing (LVSP) show similar chronaxie and rheobase values. This study provides crucial data for optimizing LBBP device programming, including pulse duration and battery longevity.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Left bundle branch pacing (LBBP) is increasingly used clinically.
- Fundamental pacing parameters like chronaxie and rheobase for LBBP are not well-established.
Purpose of the Study:
- To determine strength-duration curves, chronaxie, and rheobase for LBBP and left ventricular septal pacing (LVSP).
- To analyze battery current drain and selective LBBP at short pulse durations (PD).
Main Methods:
- Strength-duration curves were calculated for 141 patients with permanent LBBP and LVSP at six different PDs.
- Battery current drain and selective LBBP were assessed.
- LBBP data were compared with prior His-bundle pacing (HBP) data from 127 patients.
Main Results:
- LBBP and LVSP demonstrated similar chronaxie (0.38 vs 0.39 ms) and identical rheobase values (0.27 V).
- LBBP chronaxie was significantly lower than HBP (0.38 vs 0.53 ms), with similar rheobase values.
- Selective LBBP capture occurred in 19% and 41% of patients at PDs of 0.06 ms and 0.03 ms, respectively.
- Lowest battery current drain was observed at a PD of 0.2 ms with a +1 V safety margin.
Conclusions:
- Strength-duration curves for LBBP and LVSP offer insights into optimizing pacing device programming.
- Findings guide optimal selection of pulse duration, voltage amplitude, and battery longevity for LBBP.
- Data aids in understanding and achieving selective capture with LBBP devices.
