Conduction system pacing guided by 3d-electroanatomic mapping system preserves systolic function in paediatric patients

• Published in: Europace (London, England) England), 2023-05, Vol.25 (Supplement_1)
• Main Authors: Silvetti, M S, Saputo, F A, Mizzon, C, Tamburri, I, Campisi, M, Battista, V, Silvetti, G, Cazzoli, I, Raimondo, C, Drago, F
• Format: Article
• Language: English
• ISSN: 1099-5129; 1532-2092
• DOI: 10.1093/europace/euad122.372

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction Paediatric transvenous permanent pacing from alternative ventricular sites including conduction system pacing may prevent ventricular dyssynchrony and systolic dysfunction. These procedures may be difficult and require higher fluoroscopic exposures. The use of three-dimensional-electroanatomic mapping system (3D-EAM) may guide lead implantation toward these alternative sites and reduce fluoroscopic exposure. Purpose of this study is the outcome of 3D-EAM-guided alternative sites pacing in paediatric patients. Methods Retrospective analysis of children and young patients with congenital or acquired complete atrioventricular block (CAVB) with or without other congenital heart disease (CHD) who underwent 3D-EAM-guided transvenous pacing in alternative sites of the subpulmonary ventricle, to perform non-selective His bundle pacing (NSHBP), pacing of ventricular septum close to conduction system (VS-CSP) or outflow tract (OT). 3D-pacing map guided stylet-directed screw-in lead implantation toward septal sites with narrower paced QRS. Procedure and follow-up data were recorded. Parameters of ECG (QRS duration, left ventricular activation time, LVAT), echocardiogram (3D ejection fraction, EF, global longitudinal strain, GLS, of the systemic ventricle) and lead (threshold, sensing) were registered and compared at baseline (pre-implantation) and during follow-up (1-3-year). Data are reported as median (25th-75th centiles). P