{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:49:45Z","timestamp":1777891785840,"version":"3.51.4"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,11,30]],"date-time":"2020-11-30T00:00:00Z","timestamp":1606694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Conventional His bundle pacing (HBP) can be technically challenging and fluoroscopy-intense, particularly in patients with His-Purkinje conduction disease (HPCD). Three-dimensional electroanatomical mapping (EAM) facilitates non-fluoroscopic lead navigation and HB electrogram mapping. We sought to assess the procedural outcome of routine EAM-guided HBP compared with conventional HBP in a real-world population and evaluate the feasibility and safety of EAM-guided HBP in patients with HPCD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results\u2003<\/jats:title>\n                  <jats:p>We included 58 consecutive patients (72\u2009\u00b1\u200913\u2009years; 71% male) who underwent an attempt to conventional (EAM\u2212 group; n\u2009=\u200929) or EAM-guided (EAM+ group; n\u2009=\u200929) HBP between June 2019 and April 2020. The centre\u2019s learning curve was initially determined (n\u2009=\u200940 cases) to define the conventional control group and minimize outcome bias favouring EAM-guided HBP. His bundle pacing was successful in 26 patients (90%) in the EAM+ and 27 patients (93%) in the EAM\u2212 group (P\u2009=\u20090.64). The procedure time was 90 (73\u2013135) and 110 (70\u2013130) min, respectively (P\u2009=\u20090.89). The total fluoroscopy time [0.7 (0.5\u20131.4) vs. 3.3 (1.4\u20136.5) min; P\u2009&amp;lt;\u20090.001] and fluoroscopy dose [21.9 (9.1\u201347.7) vs. 78.6 (27.2\u2013144.9) cGycm2; P\u2009=\u20090.001] were significantly lower in the EAM+ than EAM\u2212 group. There were no significant differences between groups in His capture threshold (1.2\u2009\u00b1\u20090.6 vs. 1.4\u2009\u00b1\u20091.0\u2009V\/1.0\u2009ms; P\u2009=\u20090.33) and paced QRS duration (113\u2009\u00b1\u200915 vs. 113\u2009\u00b1\u200917\u2009ms; P\u2009=\u20090.89). In patients with HPCD, paced QRS duration was similar in both groups (121\u2009\u00b1\u200915 vs. 123\u2009\u00b1\u200912\u2009ms; P\u2009=\u20090.77). The bundle branch-block recruitment threshold tended to be lower in the EAM+ than EAM\u2212 group (1.3\u2009\u00b1\u20090.7 vs. 1.8\u2009\u00b1\u20091.2\u2009V\/1.0\u2009ms; P\u2009=\u20090.31). No immediate procedure-related complications occurred. One patient (2%) experienced lead dislodgement during 4-week follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion\u2003<\/jats:title>\n                  <jats:p>Implementation of routine EAM-guided HBP lead implantation is feasible and safe in a real-world cohort of patients with and without HPCD and results in a tremendous reduction in radiation exposure without prolonging procedure time or increasing procedure-related complications.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euaa292","type":"journal-article","created":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T19:12:29Z","timestamp":1599592349000},"page":"409-420","source":"Crossref","is-referenced-by-count":15,"title":["Impact of electroanatomical mapping-guided lead implantation on procedural outcome of His bundle pacing"],"prefix":"10.1093","volume":"23","author":[{"given":"Sergio","family":"Richter","sequence":"first","affiliation":[{"name":"Department of Electrophysiology, Heart Center, University of Leipzig, Str\u00fcmpellstr. 39, 04289 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Micaela","family":"Ebert","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Center, University of Leipzig, Str\u00fcmpellstr. 39, 04289 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Livio","family":"Bertagnolli","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Center, University of Leipzig, Str\u00fcmpellstr. 39, 04289 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roman","family":"Gebauer","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Heart Center, University of Leipzig, Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Lucas","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Center, University of Leipzig, Str\u00fcmpellstr. 39, 04289 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"Scheller","sequence":"additional","affiliation":[{"name":"Department of Therapy Specialists, Electrophysiology, Abbott Medical GmbH, Eschborn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingo","family":"Paetsch","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Center, University of Leipzig, Str\u00fcmpellstr. 39, 04289 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerhard","family":"Hindricks","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Center, University of Leipzig, Str\u00fcmpellstr. 39, 04289 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"D\u00f6ring","sequence":"additional","affiliation":[{"name":"Department of Electrophysiology, Heart Center, University of Leipzig, Str\u00fcmpellstr. 39, 04289 Leipzig, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,11,30]]},"reference":[{"key":"2021031520095226400_euaa292-B1","first-page":"e333","article-title":"2018 ACC\/AHA\/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: executive summary: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm 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pacing","volume":"71","author":"Abdelrahman","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2021031520095226400_euaa292-B5","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.hrthm.2017.10.014","article-title":"Permanent his-bundle pacing as an alternative to biventricular pacing for cardiac resynchronization therapy: a multicenter experience","volume":"15","author":"Sharma","year":"2018","journal-title":"Heart Rhythm"},{"key":"2021031520095226400_euaa292-B6","doi-asserted-by":"crossref","first-page":"3112","DOI":"10.1016\/j.jacc.2018.09.073","article-title":"His resynchronization versus biventricular pacing in patients with heart failure and left bundle branch block","volume":"72","author":"Arnold","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2021031520095226400_euaa292-B7","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1111\/jce.14064","article-title":"His bundle pacing, learning curve, procedure characteristics, safety, and feasibility: insights from a large international observational study","volume":"30","author":"Keene","year":"2019","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2021031520095226400_euaa292-B8","doi-asserted-by":"crossref","first-page":"e006967","DOI":"10.1161\/CIRCEP.118.006967","article-title":"Low fluoroscopy permanent his bundle pacing using electroanatomic mapping: a feasibility study","volume":"12","author":"Sharma","year":"2019","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2021031520095226400_euaa292-B9","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s10840-019-00660-6","article-title":"Comparison between His-bundle pacing guided by Ensite NavX system and conventional fluoroscopy","volume":"57","author":"Hu","year":"2020","journal-title":"J Interv Card Electrophysiol"},{"key":"2021031520095226400_euaa292-B10","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1016\/j.hrthm.2016.03.040","article-title":"How to perform permanent His bundle pacing in routine clinical practice","volume":"13","author":"Dandamudi","year":"2016","journal-title":"Heart Rhythm"},{"key":"2021031520095226400_euaa292-B11","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1093\/eurheartj\/ehz794","article-title":"Electroanatomical mapping-guided His bundle pacing in acquired dextroposition of the heart","volume":"41","author":"Richter","year":"2020","journal-title":"Eur Heart J"},{"key":"2021031520095226400_euaa292-B12","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.hrthm.2017.10.039","article-title":"Permanent His bundle pacing: recommendations from a multicenter his bundle pacing collaborative working group for standardization of definitions, implant measurements, and follow-up","volume":"15","author":"Vijayaraman","year":"2018","journal-title":"Heart Rhythm"},{"key":"2021031520095226400_euaa292-B13","doi-asserted-by":"crossref","first-page":"e006816","DOI":"10.1161\/CIRCEP.118.006816","article-title":"Device programming for His bundle pacing","volume":"12","author":"Burri","year":"2019","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2021031520095226400_euaa292-B14","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1016\/j.jacep.2018.07.013","article-title":"The efficacy of His bundle pacing: lessons learned from implementation for the first time at an experienced electrophysiology center","volume":"4","author":"Bhatt","year":"2018","journal-title":"JACC Clin Electrophysiol"},{"key":"2021031520095226400_euaa292-B15","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1111\/jce.14366","article-title":"Electrogram-only guided approach to his bundle pacing with minimal fluoroscopy: a single-center experience","volume":"31","author":"Zanon","year":"2020","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2021031520095226400_euaa292-B16","doi-asserted-by":"crossref","first-page":"e006801","DOI":"10.1161\/CIRCEP.118.006801","article-title":"Direct visualization of the His bundle pacing lead placement by 3-dimensional electroanatomic mapping: technique, anatomy, and practical considerations","volume":"12","author":"Orlov","year":"2019","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"2021031520095226400_euaa292-B17","doi-asserted-by":"crossref","first-page":"1952","DOI":"10.1093\/europace\/eux378","article-title":"Safety profile of near-zero fluoroscopy atrial fibrillation ablation with non-fluoroscopic catheter visualization: experience from 1000 consecutive procedures","volume":"20","author":"Sommer","year":"2018","journal-title":"Europace"},{"key":"2021031520095226400_euaa292-B18","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/jce.12550","article-title":"Sensor-based electromagnetic navigation to facilitate implantation of left ventricular leads in cardiac resynchronization therapy","volume":"26","author":"Doring","year":"2015","journal-title":"J Cardiovasc 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