Conduction System Pacing in France in 2022: A Snapshot Survey from the Working Group of Pacing and Electrophysiology of the French Society of Cardiology.
ARCHIVES OF CARDIOVASCULAR DISEASES（2023）
Univ Hosp Ctr Caen
Abstract
Background: Conduction system pacing (CSP) is an emerging and promising approach for physiological ventricular pacing. While data from randomized controlled trials are scarce, use of His-bundle pacing (HBP) and left bundle branch area pacing (LBBAP) has increased in France. Aim: To perform a national snapshot survey for cardiac electrophysiologists to evaluate adoption of CSP in France. Methods: An online survey, distributed to every senior cardiac electrophysiologist in France, was con-ducted in November 2022. Results: A total of 120 electrophysiologists completed the survey. Eighty-three (69%) respondents reported experience in undertaking CSP procedures and 27 (23%) were planning to start performing CSP in the coming 2 years. The implantation techniques and criteria used for successful implantation differed significantly among operators. The most frequent indications for HBP and LBBAP were high-degree atri-oventricular block with left ventricular ejection fraction (LVEF) < 40% (24 and 82%, respectively) or with LVEF >= 40% (27 and 74%, respectively), and after failure of a coronary sinus left ventricular lead (27 and 71%, respectively). The limitations respondents most frequently perceived when performing HBP were bad sensing/pacing parameters (45%), increased procedure duration (41%) and risk of lead dislodgement (30%). The most frequently perceived limitations to performing LBBAP were absence of guidelines or consensus (31%), lack of medical training (23%) and increased procedure duration (23%).Conclusions: Our national survey-based study supports wide adoption of CSP in France. CSP is cur-rently used as a second-line approach for both antibradycardia and resynchronization indications, with important variations regarding implantation techniques and criteria for measuring success.(c) 2023 Elsevier Masson SAS. All rights reserved.
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Key words
Conduction system pacing,Cardiac resynchronization therapy,Left bundle branch area pacing,His -bundle pacing,Survey
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