{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:22:27Z","timestamp":1773008547174,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T00:00:00Z","timestamp":1706054400000},"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":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Conduction system pacing (CSP) is increasingly utilized to prevent and correct dyssynchrony. Barriers to CSP adoption include limited training, methodologic variability, laboratory slot allocation, and few data on learning curves. We report learning curves\/clinical outcomes from a single experienced electrophysiologist who was new to CSP, and share gained insights.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis of all patients who underwent attempted CSP implantation (2016\u20132023). Patient characteristics, ECGs, echocardiograms, fluoroscopy\/procedure times, lead data were recorded at implant and follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CSP leads were implanted successfully in 167\/191(87.4%) patients with a follow\u2010up of 278\u00a0\u00b1\u00a0378 days. His\u2010bundle pacing (HBP\u00a0=\u00a059) and left\u2010bundle\u2010area pacing (LBAP\u00a0=\u00a0108) had similar procedure\/fluoroscopy times, QRS duration decreases, and ejection fraction improvements (all <jats:italic>p<\/jats:italic>\u00a0&gt;\u00a0NS). Eight HBP lead revisions were required for high capture thresholds LBAP demonstrated lower pacing thresholds, higher lead impedances, and greater R\u2010wave amplitudes at implant and follow\u2010up. After 25 HBP cases, implant pacing thresholds, fluoroscopy, procedural times did not decrease. After 25 LBAP cases, there were significant decreases in all these parameters (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). A separate analysis in LBAP patients with recorded Purkinje signals showed no differences in paced ECG characteristics between patients with pre\u2010 QRS Purkinje signals versus patients with Purkinje signals post\u2010QRS onset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Experienced implanters who are new to CSP can achieve steady\u2010state procedural\/fluoroscopy times after a learning curve of 25 implants. LBAP showed lower capture thresholds and higher success rates. Adequate depth of lead deployment (as determined by published parameters) does not require Purkinje potential to be pre\u2010QRS. Operators new to CSP.can forego HBP and directly implement LBAP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.14926","type":"journal-article","created":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T11:03:55Z","timestamp":1706094235000},"page":"211-221","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Single operator experience, learning curve, outcomes, and insights gained with conduction system pacing"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3126-8432","authenticated-orcid":false,"given":"William","family":"Marion","sequence":"first","affiliation":[{"name":"Sidney Kimmel Medical College Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"John D.","family":"Schanz","sequence":"additional","affiliation":[{"name":"Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonali","family":"Patel","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0117-235X","authenticated-orcid":false,"given":"Michael Lawrenz","family":"Co","sequence":"additional","affiliation":[{"name":"Division of Cardiology Section of Cardiac Electrophysiology Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1240-7812","authenticated-orcid":false,"given":"Behzad B.","family":"Pavri","sequence":"additional","affiliation":[{"name":"Division of Cardiology Section of Cardiac Electrophysiology Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.02.048"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euac201"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euab164"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac445"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.06.006"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2022.12.022"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.12.031"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14064"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.695531"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.24022"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2023.08.031"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14377"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20101827.1988.tb02315.x"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.19102\/icrm.2016.070402"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14366812"}],"container-title":["Pacing and Clinical Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pace.14926","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T15:31:14Z","timestamp":1711121474000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pace.14926"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,24]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1111\/pace.14926"],"URL":"https:\/\/doi.org\/10.1111\/pace.14926","archive":["Portico"],"relation":{},"ISSN":["0147-8389","1540-8159"],"issn-type":[{"value":"0147-8389","type":"print"},{"value":"1540-8159","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,24]]},"assertion":[{"value":"2023-11-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}