AUTHOR=Zheng Nan , Jiang Longfu , Shen Jiabo , Zhong Jinyan 

TITLE=Guidance on left bundle branch pacing using continuous pacing technique and changes in lead V1 characteristics under real-time monitoring

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1195509

DOI=10.3389/fcvm.2023.1195509

ISSN=2297-055X

ABSTRACT=Background: The changes in the morphology and characteristics of the V1 leads during left bundle branch capturing still need to be fully understood.
Objective: This study aims to provide some suggestions about the LBB capture process through the morphology and characteristics of the V1 lead.
Method: LBBP using the continuous pacing and morphology monitoring technique during screw-in using a revolving connector (John Jiang’s connecting cable). The morphology and features of V1 leads are recorded by continuous monitoring technology.
Results: The most common morphology in the LVSP stage is QR, while in the NS-LBBP (low output) stage and the NS-LBBP (lower output) stage, it is rSR. In the S-LBBP stage, it is rsR. The predominant morphology is with r/R waves in S-LBBP, which includes variations like rSR, rsR, rSr, rsr, rR, rs, rS, and R type, making up 96.7% of the total. The r waves in lead V1 are associated with agitated myocardium conducted from the left bundle branch.
Conclusion: The initial r-wave in lead V1 may be a marker during the follow-up of patients with selective LBB capture.