{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:13:32Z","timestamp":1770336812158,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"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":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Left bundle branch area pacing (LBBAP) aims to capture the cardiac conduction system in area of the left bundle branch. Currently, LBBAP is mainly performed using lumen\u2010less pacing leads (LLLs) with preshaped sheath. However, the data on LBBAP with stylet\u2010driven leads (SDLs) without sheath is limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study presents the feasibility, safety, and pacing characteristics of LBBAP using SDLs without the support of sheath.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 25 patients with bradycardia indications who received LBBAP implantation with an attempt of SDL (FINELINE II 4471 lead, Boston Scientific, MA, US) between August 2020 and April 2021 at Sir Run Run Shaw Hospital were included in this retrospective cohort study. Twenty of them finally were paced with SDL in priority (SDL\u2010LBBAP group). Twenty propensity score matching patients who underwent LBBAP with LLL (Select Secure 3830 lead, Medtronic, MN, US) and 20 right ventricular septal pacing (RVSP) with regular active fixation lead respectively in the same period (the LLL\u2010LBBAP group and RVSP group) were compared using ECG characteristics, pacing parameters and complications during 6\u2010month follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>LBBAP was successful with SDL in 23 of 25 patients (92%) and 20 of them were paced with SDL first. In the SDL\u2010LBBAP group, the average age was 70.4 \u00b1 8.2 years, and 55% of patients were male. Paced QRS duration and the stimulus to peak left ventricular activation time (Sti\u2010LVAT) in SDL\u2010LBBAP group were similar with those in LLL\u2010LBBAP group and significantly shorter than those in RVSP group (126.1\u00b114.1\u00a0ms vs. 124.8\u00b110.9\u00a0ms, <jats:italic>p\u00a0<\/jats:italic>=\u00a01.00; 77.7\u00a0\u00b1\u00a011.2\u00a0ms vs. 73.5\u00a0\u00b1\u00a09.3\u00a0ms, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.75; 126.1\u00a0\u00b1\u00a014.1\u00a0ms vs. 147.7\u00a0\u00b1\u00a022.5\u00a0ms, <jats:italic>P<\/jats:italic>&lt;.001; 77.7\u00a0\u00b1\u00a011.2\u00a0ms vs. 97.0\u00a0\u00b1\u00a013.2\u00a0ms, <jats:italic>P<\/jats:italic>&lt;.001). The pacing threshold and R\u2010wave amplitude of SDL\u2010LBBAP group were 0.53\u00a0\u00b1\u00a00.18V and 11.53\u00a0\u00b1\u00a03.63\u00a0mV at baseline respectively, which were comparable with the other two groups. During the 6\u2010month follow\u2010up, the pacing parameters remained stable and no lead\u2010related complications were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>It is feasible and safe to use stylet\u2010directed pacing lead for permanent LBBAP without a delivery sheath. Similar to LLL, LBBAP using SDL showed stable parameters and narrower paced QRS duration compared with RVSP, which could be an alternative to LLL in LBBAP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.14504","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T07:29:31Z","timestamp":1650353371000},"page":"993-1003","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Preliminary experience of permanent left bundle branch area pacing using stylet\u2010directed pacing lead without delivery sheath"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5457-7855","authenticated-orcid":false,"given":"Yaxun","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Cardiology Sir Run Run Shaw Hospital College of Medicine Zhejiang University  Hangzhou 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Hospital College of Medicine Zhejiang University  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Cardiology Sir Run Run Shaw Hospital College of Medicine Zhejiang University  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Sir Run Run Shaw Hospital College of Medicine Zhejiang University  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Sir Run Run Shaw Hospital College of Medicine Zhejiang University  Hangzhou 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