Intracardiac echocardiography-guided left bundle branch pacing

Objective To investigate the role and method of intracardiac echocardiography (ICE) in left bundle branch pacing. Methods A total of 12 patients who underwent ICE guided left bundle branch pacing from February 2018 to June 2018 in department of cardiology of the First People’s Hospital of Yunnan Province. The patients’ sex, age, weight, disease history, and the results of color Doppler echocardiography were recorded before surgery.The duration of surgery, X-ray exposure, pacing parameters (threshold, perception, impedance) , electrocardiogram (ECG) characteristics, pacing parameters, clinical symptoms and echocardiographic results were recorded after surgery. Results The left bundle branch pacing guided by ICE was successfully in all 12 patients. There were 4 cases of sick sinus syndrome, 6 cases of atrioventricular block, 2 cases of atrial fibrillation with long R-R interval.The mean operation time was (1.75±0.28) hours, and the X-ray exposure was (61.2±13.6) mGy. The implantation time of left bundle branch electrode was (1.23±0.24) hours, X-ray exposure of left bundle branch electrode implantation was (48.9±12.3) mGy. There was no electrode dislocation, pneumothorax or infection after operation. Two of them had a small hematoma of the pacemaker pocket, hematoma disappeared after compression. Conclusion Feasibility of ICE guidance for left bundle branch pacing, which may increase the success rate and reduce the risk of surgery. Key words: Cardiac pacing, artificial; Intracardiac echocardiography; Left bundle branch