2.3 Conventional interrupted LBBAP implantation with comparison of connector-pin pacing versus lead stylet-pacing
Ten patients were implanted according to the conventional interrupted pace mapping technique (validation-group), as previously described.[5,8] Briefly, implantation was started with 4 to 6 rapid manual clockwise rotations of the outer lead body. Subsequently, additional steps of 2 rotations were performed until successful LBBAP was demonstrated.
After the initial rotations and after each additional step, unipolar pacing characteristics were compared between pacing from the CP and from the LS. For this purpose, pacing cables were alternately connected to the CP and to the LS as a cathode, while the patient’s body connection served as anode (Figure 1). Unipolar pacing characteristics (impedance and paced QRS morphology) and local electrograms were recorded using the Renamic programmer as generator (Biotronik, SE & Co, KG, Berlin, Germany) and an electrophysiology recording system (BARD Labsystem, C.R Bard Inc, Lowell, MA, USA), for off-line comparison. For ethical reasons, during each rotations step pacing cables were connected to the lead stylet for unipolar LS pacing, in order to avoid lead perforation.