{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:28:55Z","timestamp":1790738935580,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T00:00:00Z","timestamp":1580688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>His bundle pacing (HBP) is the most physiological pacing. The standard technique based on fluoroscopic approach might be challenging and fluoro consuming. Targeting the His guided exclusively by the electrical signals could enable a precise lead implant, thus reducing fluoroscopy time (FT) and X\u2010ray dose, desirable both for patients and operators. The aim of the study is to evaluate the feasibility, efficacy, and safety both acutely and at 30 days of the electrogram (EGM)\u2010guided HBP with minimal or no fluoroscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Between October and December 2018, 41 consecutive patients underwent EGM\u2010guided HBP. Successful HBP was obtained in 39 (95%) patients, (30 males, 78\u2009\u00b1\u200910 years). Selective HBP (S\u2010HBP) was achieved in 23 (59%), nonselective HBP (NS\u2010HBP) in 16 (41%) patients. The final HBP lead position was reached in 31 (79.4%) patients without fluoroscopy, only guided by electrical signals. In eight patients a minimal fluoroscopy (mean, 8\u2009seconds) has been required. The sheath's cutting and the slack of the lead were routinely performed under fluoroscopy. No difference was observed in FT for HBP lead placement in S\u2010HBP and NS\u2010HBP (mean, 8.1\u2009\u00b1\u200925 vs 7.5\u2009\u00b1\u200920\u2009seconds, <jats:italic>P<\/jats:italic>\u2009=\u2009.8; median value 0 vs 0\u2009seconds). No differences were observed in FT for the entire procedure, total dose area product and total procedural time in S\u2010HBP and NS\u2010HBP. Lead dislodgement occurred in one (2.6%) patient 1 day after the procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>HBP could be performed safely and efficiently using the EGMs, with minimal or no fluoroscopy. Fluoroscopy was required during sheath removal and atrial lead placement.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14366","type":"journal-article","created":{"date-parts":[[2020,1,24]],"date-time":"2020-01-24T12:46:08Z","timestamp":1579869968000},"page":"805-812","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Electrogram\u2010only guided approach to His bundle pacing with minimal fluoroscopy: A single\u2010center experience"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2673-3918","authenticated-orcid":false,"given":"Francesco","family":"Zanon","sequence":"first","affiliation":[{"name":"Arrhythmia and Electrophysiology Unit, Cardiology Department Santa Maria Della Misericordia Hospital, Italy  Rovigo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Marcantoni","sequence":"additional","affiliation":[{"name":"Arrhythmia and Electrophysiology Unit, Cardiology Department Santa Maria Della Misericordia Hospital, Italy  Rovigo"},{"name":"Department of Cardiology Santa Maria della Misericordia Hospital  Rovigo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Zuin","sequence":"additional","affiliation":[{"name":"Department of Cardiology Santa Maria della Misericordia Hospital  Rovigo Italy"},{"name":"Section of Internal and Cardiopulmonary Medicine University of Ferrara  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4040-3838","authenticated-orcid":false,"given":"Gianni","family":"Pastore","sequence":"additional","affiliation":[{"name":"Arrhythmia and Electrophysiology Unit, Cardiology Department Santa Maria Della Misericordia Hospital, Italy  Rovigo"},{"name":"Department of Cardiology Santa Maria della Misericordia Hospital  Rovigo 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