Criteria for Determining Successful Capture of Left Bundle Branch Pacing
Left bundle branch pacing(LBBP)is defined as the capture of the left bundle branch by pacing,including the capture of left bundle branch trunk and its branches(with or without peripheral myocardial)and the low capture threshold(less than 1.5 V/0.4 ms).The recording of retrograde His bundle potential or anterograde left bundle branch potential is the direct evidence of left bundle branch capture,but the operation is more complex and less used in clinical practice.During pacemaker lead implantation,electrocardiogram(ECG)changes are usually used to determine whether the lead successfully captured the left bundle branch.Specifically,it includes changes in the shape of QRS wave in body surface ECG,changes in left ventricular activation time,detection of left bundle branch potential or injury current in intracavitary ECG,and observation of non-selective LBBP switching to selective LBBP or left ventricular septal pacing when pacing output is changed.Due to individual differences in patients,some scholars have proposed personalized methods such as left ventricular peak time,V6-V1 peak interval,and LBBP score to further supplement the capture criteria.This review aims to summarize the commonly used criteria at present and provide more evidence for clinical operation to improve the success rate of LBBP surgery.
Left bundle branch pacingCriteria for capture of left bundle branchLeft bundle branch potentialCurrent of injuryLeft ventricular activation time