{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T03:04:27Z","timestamp":1784689467262,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"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":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The majority of data on left bundle branch area pacing (LBBAP) are on a lumenless lead. Data on the safety and effectiveness of stylet driven leads are comparatively lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 265 patients who underwent attempted LBBAP with an 7842 (Boston Scientific, Marlborough, MA) lead in the Duke University Health System between 1\/1\/2020 and 9\/1\/2023. Outcomes of interest included post\u2010operative 7842 helix extension (\u22652 helix rotations beyond the lead tip), complications, and lead parameters. A nested analysis of single and dual chamber LBBAP attempts was performed to compare outcomes among similar patients who underwent attempted LBBAP with the lumenless 3830 (Medtronic, Mineappolis, MN) lead.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>LBBAP success with 7842 was 89.8%. Characteristics were similar among patients with (<jats:italic>n<\/jats:italic>\u2009=\u2009238) and without (<jats:italic>n<\/jats:italic>\u2009=\u200927) successful implants. Helix extension was evaluable for 222 of 238 successful 7842 implants. Of evaluable leads, helix extension was complete for 174 leads (78%), and partial for 48 (21.6%). A trend towards lower dislodgement rates was observed in patients with full versus partial extension (2.9% vs. 8.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.0895) and the rate of full helix extension increased over time (64.1% over 24 months vs. 81.4% over 21 months, <jats:italic>p<\/jats:italic>\u2009=\u20090.0162). The success rate of 3830 LBBAP implants (<jats:italic>n<\/jats:italic>\u2009=\u2009140) was 92.8% (<jats:italic>p<\/jats:italic>\u2009=\u20090.069 <jats:italic>vs.<\/jats:italic> 7842). At implant, R waves were similar for 7842 and 3830 leads but were greater for 7842 during follow\u2010up (14.4\u2009+\u2009\/\u22120.77 vs. 11.3\u2009+\u2009\/\u22120.68, <jats:italic>p<\/jats:italic>\u2009=\u20090.004). Pacing impedances were higher with 7842 compared with 3830 at baseline (838\u2009+\u2009\/\u221210.44 ohms vs. 772\u2009+\u2009\/\u221214.58 ohms, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and during follow\u2010up (652\u2009+\u2009\/\u221211.0 ohms vs. 513\u2009+\u2009\/\u22129.18 ohms, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001); similarly, 7842 pacing thresholds (@ 0.4\u2009ms) were slightly higher at baseline (0.85\u2009V\u2009+\u2009\/\u22120.03 vs. 0.68\u2009V\u2009+\u2009\/\u22120.03, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and 6 months (0.95\u2009V\u2009+\u2009\/\u22120.03 vs. 0.80\u2009V\u2009+\u2009\/\u22120.03, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) compared with those for the lumenless 3830.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>LBBAP implant success rates, complications, and pacing parameters using the 7842 lead are stable over time, and appeared overall similar to the 3830 lead. Incomplete 7842 helix extension is a modifiable risk factor for lead dislodgement.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.16586","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T06:29:52Z","timestamp":1738218592000},"page":"771-780","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Use of a Stylet Driven Lead With a Flexible Neck for Left Bundle Branch Area Pacing: A Single Center Experience"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6984-815X","authenticated-orcid":false,"given":"Sara A.","family":"Coles","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Hospital Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilya Y.","family":"Shadrin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Hospital Durham North Carolina USA"},{"name":"Duke Clinical Research Institute Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sana M.","family":"Al\u2010Khatib","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Hospital Durham North Carolina USA"},{"name":"Duke Clinical Research Institute Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0772-2404","authenticated-orcid":false,"given":"Jonathan P.","family":"Piccini","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Hospital Durham North Carolina USA"},{"name":"Duke Clinical Research Institute Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9371-1180","authenticated-orcid":false,"given":"Albert Y.","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Hospital Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9616-9219","authenticated-orcid":false,"given":"James P.","family":"Daubert","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Hospital Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald D.","family":"Hegland","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Hospital Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille G.","family":"Frazier\u2010Mills","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Hospital Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean D.","family":"Pokorney","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Hospital Durham North Carolina USA"},{"name":"Duke Clinical Research Institute Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2948-1333","authenticated-orcid":false,"given":"Kevin P.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Hospital Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin L.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Hospital Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0195-1081","authenticated-orcid":false,"given":"Larry R.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Hospital Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8140-9822","authenticated-orcid":false,"given":"Robert K.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Hospital Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9001-506X","authenticated-orcid":false,"given":"Tristram D.","family":"Bahnson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Hospital Durham North Carolina 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North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,29]]},"reference":[{"issue":"8","key":"e_1_2_7_2_1","first-page":"e382","article-title":"2018 ACC\/AHA\/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society","volume":"140","author":"Kusumoto F. 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