Publications by authors named "Alvaro Estevez-Paniagua"
Background: Variation in human left bundle branch (LBB) anatomy has a significant effect on the sequence of left ventricular depolarization. However, little is known regarding the electrophysiological characteristics of pacing different LBB fascicles.
Objective: We aimed to analyse the different electrocardiographic characteristics of LBB pacing (LBBP) attending to the site of pacing at the LBB system.
Background: Electrocardiographic (ECG)-based criteria are used to confirm left bundle branch (LBB) pacing (LBBP), but current cutoff values have never been validated for different pacing locations.
Objective: The purpose of this study was to describe diagnostic performance of V6-R wave peak time (RWPT), V6-V1 interpeak interval, and aVL-RWPT for different pacing sites within the LBB and to determine 100% specific values for each criterion at each pacing location.
Methods: Consecutive patients with confirmed LBBP were selected.
Background: QRS transition criteria during dynamic manoeuvers are the gold-standard for non-invasive confirmation of left bundle branch (LBB) capture, but they are seen in <50% of LBB area pacing (LBBAP) procedures.
Objective: We hypothesized that transition from left ventricular septal pacing (LVSP) to LBB pacing (LBBP), when observed during lead penetration into the deep interventricular septum (IVS) with interrupted pacemapping, can suggest LBB capture.
Methods: QRS transition during lead screwing-in was defined as shortening of paced V6-R wave peak time (RWPT) by ≥10 ms from LVSP to non-selective LBBP (ns-LBBP) obtained during mid to deep septal lead progression at the same target area, between two consecutive pacing manoeuvres.
Introduction: The role that preprocedural factors have on atrioventricular synchrony (AVS) provided by leadless pacemakers requires investigation.
Methods And Results: We aimed to assess the correlation between mitral inflow echocardiographic parameters and p-wave morphology with the accelerometer A4 signal amplitude. We also sought to identify clinical and echocardiographic predictors of optimal ambulatory AVS (≥85% of cardiac cycles).
Aims: Most of the criteria used to diagnose direct capture of the left bundle branch (LBB) have never been validated in an external sample. We hypothesized that lead aVL might add relevant information, and the combination of several electrocardiograph (ECG)-based criteria might discriminate better LBB capture from left ventricular septal (LVS) capture, than each criterion separately.
Methods And Results: Single-centre study involving all consecutive patients who received LBB area pacing.
Background: Performance of the leadless pacemaker capable of atrioventricular (AV) synchronous pacing in de novo patients warrants further investigation.
Objective: The aims of this study were to assess what programming changes are needed to achieve proper atrial tracking and to study the percentage of AV synchrony (AVS) the device can provide under real-world conditions.
Methods: Consecutive patients undergoing Micra AV implantation between June 2020 and November 2021 were studied.