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Feasibility and Safety of Zero-Fluoroscopy Left Bundle Branch Pacing: An Initial Experience.
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  • Javier Ramos,
  • Jorge Melero Polo,
  • Isabel Montilla-Padilla,
  • Jose Ramón Ruiz Arroyo,
  • Mercedes Cabrera
Javier Ramos
Hospital Clinico Universitario Lozano Blesa

Corresponding Author:[email protected]

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Jorge Melero Polo
Hospital Clinico Universitario Lozano Blesa
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Isabel Montilla-Padilla
Hospital Clinico Universitario Lozano Blesa
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Jose Ramón Ruiz Arroyo
Hospital Clinico Universitario Lozano Blesa
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Mercedes Cabrera
Hospital Clinico Universitario Lozano Blesa
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Abstract

Introduction Left bundle branch pacing (LBBP) has emerged in recent years as a new pacing modality, providing patients with a narrower paced QRS than conventional pacing and stable pacing parameters. At the same time, there is a growing concern about the use of fluoroscopy in pacemaker implantations, given its harmful effects to both patients and operators. However, there are no prior experiences of zero fluoroscopy in LBBP procedure. Methods We conducted an observational prospective study recruiting consecutive patients that underwent zero fluoroscopy LBBP pacemaker implantation. A 6-month follow-up visit was programmed for every patient. The main goal of our study was to assess the efficacy, feasibility and safety of the procedure. Results From January 2021 to February 2022, we included 10 patients, 8 males. The average age was 63 ± 4 years. The procedure was successful in all patients. We observed a significant reduction in paced QRS width compared with basal QRS width (149 ms vs 116 ms, p= 0.02). All device parameters remained stable at 6-month follow-up: no significant differences in mean impedance (700.5 vs 494 Ohm, p=0.09), capture threshold (0.67 vs 0.83V @ 0.4ms, p=0.27) or R-wave amplitude (10.6 vs 13.92 mV, p= 0.19). No complications were reported in any case. Conclusion Zero fluoroscopy LBBP is feasible and safe, and it may be considered an optimal election in cases where radiation exposure is contraindicated or especially undesirable and as an alternative in all other cases.
18 May 2022Submitted to Journal of Cardiovascular Electrophysiology
19 May 2022Submission Checks Completed
19 May 2022Assigned to Editor
28 May 2022Reviewer(s) Assigned
27 Jun 2022Review(s) Completed, Editorial Evaluation Pending
04 Jul 2022Editorial Decision: Revise Minor
01 Sep 20221st Revision Received
02 Sep 2022Submission Checks Completed
02 Sep 2022Assigned to Editor
02 Sep 2022Reviewer(s) Assigned
07 Sep 2022Review(s) Completed, Editorial Evaluation Pending
17 Sep 2022Editorial Decision: Revise Minor
11 Oct 20222nd Revision Received
11 Oct 2022Assigned to Editor
11 Oct 2022Submission Checks Completed
11 Oct 2022Reviewer(s) Assigned
11 Oct 2022Review(s) Completed, Editorial Evaluation Pending
25 Oct 2022Editorial Decision: Revise Minor
10 Nov 20223rd Revision Received
10 Nov 2022Submission Checks Completed
10 Nov 2022Assigned to Editor
10 Nov 2022Review(s) Completed, Editorial Evaluation Pending
10 Nov 2022Reviewer(s) Assigned
22 Nov 2022Editorial Decision: Accept