{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T15:37:55Z","timestamp":1780933075692,"version":"3.54.1"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T00:00:00Z","timestamp":1597708800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Recently, left bundle branch area pacing (LBBAP) has been shown to be feasible. However, the right ventricular (RV) implantation site for LBBAP remains elusive. We believe that the RV implantation site should be located at the posteromedial basal septum, and in this paper, we propose a new method to help guide lead implantation. The aim of this study is to demonstrate the feasibility of the proposed method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The RV implantation site was positioned by a combination of a nine-grid system on fluoroscopy and the use of intracardiac echocardiogram (ICE) and then verified by ICE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifteen patients were enrolled for LBBAP using our method. The acute success rate was 86.7% (13\/15), which demonstrated that our method is useful for assisting with lead implantation. According to ICE, the distance between the implantation site and apex (the front) and the distance between the implantation site and tricuspid annulus (the back) were 44.9\u2009\u00b1\u200910.7 and 33.2\u2009\u00b1\u200910.4\u2009mm, respectively, and the ratio of the front and the back was 1.57\u2009\u00b1\u20090.80. The distance between the implantation site and the front junction point of the left-right ventricle (the upper) and the distance between the implantation site and the back junction point (the lower) were 33.4\u2009\u00b1\u200910.6 and 24.5\u2009\u00b1\u200910.2\u2009mm, respectively. The ratio of the upper to the lower was 1.76\u2009\u00b1\u20091.36. These results suggest that the implantation site was at the posteromedial basal septum. The width of the QRS duration increased from 110.4\u2009\u00b1\u200933.1\u2009ms at baseline to 114.1\u2009\u00b1\u200916.1\u2009ms post LBBAP (<jats:italic>P<\/jats:italic>\u00a0&gt;\u20090.05). The operation time was 133\u2009\u00b1\u00a032.9\u2009min. The time of X-ray fluoroscopy was 21.2\u2009\u00b1\u00a05.9\u2009min. The mean time for lead positioning during LBBAP was 33.8\u2009\u00b1\u00a016.6\u2009min. During a follow-up of 3\u2009months, the LBB capture threshold remained stable in 12 patients, except for one patient who had an increase in the LBB capture threshold to 3.0 v\/0.4\u2009ms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our preliminary results indicate that the posteromedial basal septum could be seen as the implantation site for LBBAP. As a technique for LBBAP, ICE is a useful method for assisting with lead implantation. It is feasible and safe to use a nine-grid system combined with ICE for LBBAP.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12872-020-01649-0","type":"journal-article","created":{"date-parts":[[2020,8,18]],"date-time":"2020-08-18T12:03:21Z","timestamp":1597752201000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Permanent left bundle branch area pacing utilizing intracardiac echocardiogram"],"prefix":"10.1186","volume":"20","author":[{"given":"Xiang-Fei","family":"Feng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng-Pai","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiu-Fen","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6725-0325","authenticated-orcid":false,"given":"Yi-Gang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,8,18]]},"reference":[{"key":"1649_CR1","doi-asserted-by":"publisher","first-page":"1938","DOI":"10.1016\/j.jacc.2006.01.056","volume":"47","author":"E Occhetta","year":"2006","unstructured":"Occhetta E, Bortnik M, Magnani A, Francalacci G, Piccinino C, Plebani L, Marino P. Prevention of ventricular desynchronization by permanent Para-Hisian pacing after atrioventricular node ablation in chronic atrial fibrillation: a crossover, blinded, randomized study versus apical right ventricular pacing. J Am Coll Cardiol. 2006;47:1938\u201345.","journal-title":"J Am Coll Cardiol"},{"key":"1649_CR2","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1007\/s10840-011-9565-1","volume":"31","author":"MB Kronborg","year":"2011","unstructured":"Kronborg MB, Mortensen PT, Gerdes JC, Jensen HK, Nielsen JC. His and Para-his pacing in AV block: feasibility and electrocardiographic findings. J Interv Card Electrophysiol. 2011;31:255\u201362.","journal-title":"J Interv Card Electrophysiol"},{"key":"1649_CR3","doi-asserted-by":"publisher","first-page":"1548","DOI":"10.1016\/j.hrthm.2015.03.048","volume":"12","author":"DL Lustgarten","year":"2015","unstructured":"Lustgarten DL, Crespo EM, Arkhipova-Jenkins I, Lobel R, Winget J, Koehler J, Liberman E, Sheldon T. His-bundle pacing versus biventricular pacing in cardiac resynchronization therapy patients: a crossover design comparison. Heart Rhythm. 2015;12:1548\u201357.","journal-title":"Heart Rhythm"},{"key":"1649_CR4","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1111\/pace.12604","volume":"38","author":"S Tung","year":"2015","unstructured":"Tung S, Lemaitre J. His bundle pacing: in pursuit of the \"sweet spot\". Pacing Clin Electrophysiol. 2015;38:537\u20139.","journal-title":"Pacing Clin Electrophysiol"},{"key":"1649_CR5","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1016\/j.hrthm.2017.04.003","volume":"14","author":"OA Ajijola","year":"2017","unstructured":"Ajijola OA, Upadhyay GA, Macias C, Shivkumar K, Tung R. Permanent his-bundle pacing for cardiac resynchronization therapy: initial feasibility study in lieu of left ventricular lead. Heart Rhythm. 2017;14:1353\u201361.","journal-title":"Heart Rhythm"},{"key":"1649_CR6","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.118.006613","volume":"11","author":"PS Sharma","year":"2018","unstructured":"Sharma PS, Naperkowski A, Bauch TD, Chan JYS, Arnold AD, Whinnett ZI, Ellenbogen KA, Vijayaraman P. Permanent his bundle pacing for cardiac resynchronization therapy in patients with heart failure and right bundle branch block. Circ Arrhythm Electrophysiol. 2018;11:e006613.","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"1649_CR7","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1002\/ca.20700","volume":"22","author":"RH Anderson","year":"2009","unstructured":"Anderson RH, Yanni J, Boyett MR, Chandler NJ, Dobrzynski H. The anatomy of the cardiac conduction system. Clin Anat. 2009;22:99\u2013113.","journal-title":"Clin Anat"},{"key":"1649_CR8","doi-asserted-by":"publisher","first-page":"1766","DOI":"10.1016\/j.hrthm.2019.04.043","volume":"16","author":"X Li","year":"2019","unstructured":"Li X, Li H, Ma W, Ning X, Liang E, Pang K, Yao Y, Hua W, Zhang S, Fan X. Permanent left bundle branch area pacing for atrioventricular block: feasibility, safety, and acute effect. Heart Rhythm. 2019;16:1766\u201373.","journal-title":"Heart Rhythm"},{"key":"1649_CR9","doi-asserted-by":"publisher","first-page":"3050","DOI":"10.1111\/jce.14242","volume":"30","author":"P Vijayaraman","year":"2019","unstructured":"Vijayaraman P, Panikkath R, Mascarenhas V, Bauch TD. Left bundle branch pacing utilizing three dimensional mapping. J Cardiovasc Electrophysiol. 2019;30:3050\u20136.","journal-title":"J Cardiovasc Electrophysiol"},{"key":"1649_CR10","doi-asserted-by":"crossref","unstructured":"Huang W, Su L, Wu S, Xu L, Xiao F, Zhou X, Ellenbogen KA. Benefits of permanent his bundle pacing combined with Atrioventricular node ablation in atrial fibrillation patients with heart failure with both preserved and reduced left ventricular ejection fraction. J Am Heart Assoc. 2017;6.","DOI":"10.1161\/JAHA.116.005309"},{"key":"1649_CR11","doi-asserted-by":"crossref","unstructured":"Su L, Wu S, Wang S, Wang Z, Xiao F, Shan P, Zhou H, Huang Z, Xu L, Huang W. Pacing parameters and success rates of permanent his-bundle pacing in patients with narrow QRS: a single-Centre experience. Europace. 2018.","DOI":"10.1093\/europace\/euy281"},{"key":"1649_CR12","doi-asserted-by":"crossref","unstructured":"Elizari MV: The normal variants in the left bundle branch system. Journal of electrocardiology.2017; 50:389\u201399.","DOI":"10.1016\/j.jelectrocard.2017.03.004"},{"key":"1649_CR13","doi-asserted-by":"crossref","unstructured":"Okumura Y, Henz BD, Johnson SB, Bunch TJ, O'Brien CJ, Hodge DO, Altman A, Govari A, Packer DL: Three-dimensional ultrasound for image-guided mapping and intervention: methods, quantitative validation, and clinical feasibility of a novel multimodality image mapping system. Circulation Arrhythmia and electrophysiology.2008; 1:110\u20139.","DOI":"10.1161\/CIRCEP.108.769935"},{"key":"1649_CR14","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.115.003344","volume":"9","author":"M Mafi-Rad","year":"2016","unstructured":"Mafi-Rad M, Luermans JG, Blaauw Y, Janssen M, Crijns HJ, Prinzen FW, Vernooy K. Feasibility and acute hemodynamic effect of left ventricular Septal pacing by Transvenous approach through the Interventricular septum. Circ Arrhythm Electrophysiol. 2016;9:e003344.","journal-title":"Circ Arrhythm Electrophysiol"},{"key":"1649_CR15","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1093\/europace\/euy252","volume":"21","author":"K Chen","year":"2019","unstructured":"Chen K, Li Y, Dai Y, Sun Q, Luo B, Li C, Zhang S. Comparison of electrocardiogram characteristics and pacing parameters between left bundle branch pacing and right ventricular pacing in patients receiving pacemaker therapy. Europace. 2019;21:673\u201380.","journal-title":"Europace."},{"key":"1649_CR16","doi-asserted-by":"crossref","unstructured":"Li X, Li H, Ma W, Ning X, Liang E, Pang K, Yao Y, Hua W, Zhang S, Fan X: Permanent left bundle branch area pacing for atrioventricular block: feasibility, safety and acute effect. Heart rhythm.2019.","DOI":"10.1093\/eurheartj\/ehz746.0737"},{"key":"1649_CR17","doi-asserted-by":"publisher","first-page":"2278","DOI":"10.1161\/CIRCULATIONAHA.117.031343","volume":"137","author":"A Enriquez","year":"2018","unstructured":"Enriquez A, Saenz LC, Rosso R, Silvestry FE, Callans D, Marchlinski FE, Garcia F. Use of Intracardiac echocardiography in interventional cardiology: working with the anatomy rather than fighting it. Circulation. 2018;137:2278\u201394.","journal-title":"Circulation."},{"issue":"2","key":"1649_CR18","first-page":"96","volume":"23","author":"X-F Feng","year":"2019","unstructured":"Feng X-F, Yu Y, Zhao Y, Lu Q-F, Li Y-G. Preliminary clinical application of permanent left bundle branch pacing via right axillary venous access. Chin J Cardiac Arrhyth. 2019;23(2):96\u2013101 (in Chinese).","journal-title":"Chin J Cardiac Arrhyth"},{"key":"1649_CR19","volume-title":"Mascarenhas V","author":"P Vijayaraman","year":"2019","unstructured":"Vijayaraman P, Panikkath R. Mascarenhas V. Left Bundle Branch Pacing Utilizing Three Dimensional Mapping. J Cardiovasc Electrophysiol: Bauch TD; 2019."},{"key":"1649_CR20","doi-asserted-by":"crossref","unstructured":"Li X, Li H, Ma W, Ning X, Liang E, Pang K, Yao Y, Hua W, Zhang S, Fan X. Permanent left bundle branch area pacing for atrioventricular block: feasibility, safety, and acute effect. Heart Rhythm. 2019.","DOI":"10.1093\/eurheartj\/ehz746.0737"},{"key":"1649_CR21","doi-asserted-by":"crossref","unstructured":"Chen X, Wu S, Su L, Su Y, Huang W. The characteristics of the electrocardiogram and the intracardiac electrogram in left bundle branch pacing. J Cardiovasc Electrophysiol. 2019.","DOI":"10.1111\/jce.13956"},{"key":"1649_CR22","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1111\/jce.13956","volume":"30","author":"X Chen","year":"2019","unstructured":"Chen X, Wu S, Su L, Su Y, Huang W. The characteristics of the electrocardiogram and the intracardiac electrogram in left bundle branch pacing. J Cardiovasc Electrophysiol. 2019;30:1096\u2013101.","journal-title":"J Cardiovasc Electrophysiol"},{"key":"1649_CR23","doi-asserted-by":"publisher","first-page":"1876","DOI":"10.1161\/CIRCULATIONAHA.118.038648","volume":"139","author":"GA Upadhyay","year":"2019","unstructured":"Upadhyay GA, Cherian T, Shatz DY, Beaser AD, Aziz Z, Ozcan C, Broman MT, Nayak HM, Tung R. Intracardiac delineation of Septal conduction in left bundle-branch block patterns. Circulation. 2019;139:1876\u201388.","journal-title":"Circulation."},{"key":"1649_CR24","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1016\/j.hrthm.2017.10.039","volume":"15","author":"P Vijayaraman","year":"2018","unstructured":"Vijayaraman P, Dandamudi G, Zanon F, Sharma PS, Tung R, Huang W, Koneru J, Tada H, Ellenbogen KA, Lustgarten DL. Permanent his bundle pacing: recommendations from a multicenter his bundle pacing collaborative working group for standardization of definitions, implant measurements, and follow-up. Heart Rhythm. 2018;15:460\u20138.","journal-title":"Heart Rhythm"},{"key":"1649_CR25","doi-asserted-by":"publisher","first-page":"1774","DOI":"10.1016\/j.hrthm.2019.05.011","volume":"16","author":"P Vijayaraman","year":"2019","unstructured":"Vijayaraman P, Subzposh FA, Naperkowski A, Panikkath R, John K, Mascarenhas V, Bauch TD, Huang W. Prospective evaluation of feasibility and electrophysiologic and echocardiographic characteristics of left bundle branch area pacing. Heart Rhythm. 2019;16:1774\u201382.","journal-title":"Heart Rhythm"},{"issue":"33","key":"1649_CR26","first-page":"e1","volume":"2017","author":"W Huang","year":"1736","unstructured":"Huang W, Su L, Wu S, Xu L, Xiao F, Zhou X, Ellenbogen KA. A novel pacing strategy with low and stable output: pacing the left bundle branch immediately beyond the conduction block. Can J Cardiol. 1736;2017(33):e1\u20133.","journal-title":"Can J Cardiol"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-020-01649-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-020-01649-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-020-01649-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T22:43:14Z","timestamp":1696545794000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmccardiovascdisord.biomedcentral.com\/articles\/10.1186\/s12872-020-01649-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,18]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1649"],"URL":"https:\/\/doi.org\/10.1186\/s12872-020-01649-0","relation":{},"ISSN":["1471-2261"],"issn-type":[{"value":"1471-2261","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,18]]},"assertion":[{"value":"1 December 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 August 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 August 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was approved by the Ethics Committee of Xinhua Hospital Affiliated with Shanghai Jiaotong University School of Medicine (approval number: XHEC -D-2019-055) and performed in accordance with the Declaration of Helsinki. All participants signed informed consent form.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"We do not have any financial or non-financial potential conflicts of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"377"}}