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.