Acute performance of stylet driven leads for left bundle branch area pacing: a comparison with lumenless leads

Abstract Funding Acknowledgements Type of funding sources: None. Background Lumen-less leads (LLL) and stylet driven (SDL) are currently used for left bundle branch area pacing (LBBAP). We sought to evaluate the acute performance SDL during LBBAP in comparison with LLL. Methods This is an observational retrospective study including consecutive patients undergoing at our institution.Acute lead was evaluated implant success rate,electrical parameters,ECG characteristics related complications (intraprocedure dislodgment after having being penetrated into septum stable position needing repositioning, septal perforation, coronary venous fistula, development complete AV block not previously present damage implant).Conduction system capture criteria were assessed before patient discharge asynchronous ventricular pacing. Ventricular within using paced QRS axis, fluoroscopic orthogonal views post-procedure TTE, classified as basal,mid or apical septum. Results 451 implants included, 333 LLL 118 SDL. significantly higher (91.6% vs 79.7% SDL,p=0.001).Among successful LBBAP,LBB achieved 53.2% 36.4% SDL,while (LVSP) 39% 44.1%,respectively (p<0.0001). A basal more frequently obtained (19.8% 13.3% SDL),while located mid positions (86.7% 80.1% LLL, p=0.003).Paced ECG axis inferior 43.9% 28.9% superior 24.5% 42.1%, respectively,p=0.001.Intraprocedure occurred 9.3% 2.1% LLL,p=0.001.In 5 cases (4.2%),lead replacement due helix entrapment malfunction no such registered among patients.Acute lead-related (29.1% 12.6%, respectively, p<0.0001,table 1),none them additional interventions.Among end procedure,34 (7.5%) experienced loss r prime wave V1 widening hospital discharge,more (17.8% vs. 9.4%, respectively,p<0.0001) indicative microdislodgment. Conclusions In experience,acute different between SDL.LBBAP rate percentage LBB SDL.SDL associated a septum.A procedure well rates microdislodgment implantation also seen SDL,none re-intervention.