Background: Left bundle branch area pacing (LBBAP) has been rapidly adopted despite a lack of leads with approved indications for LBBAP.
Objective: This study aims to analyze the performance of a 6Fr active fixation, stylet-driven lead in LBBAP.
Methods: The multicenter INSIGHT-LBBA registry analyzed consecutive LBBAP implant attempts with INGEVITY+ leads.
JACC Clin Electrophysiol
August 2023
Background: Dense calcifications encasing pacing leads with long dwell times are common and increase the difficulty of and risks associated with transvenous lead extraction procedures (TLE). Shockwave intravascular lithotripsy (IVL) focuses sound waves to fracture calcified tissue within a narrow radius to the catheter.
Objectives: This study sought to assess the impact of Shockwave IVL pretreatment during extraction of long dwell time pacemaker and defibrillator leads.
When a tissue becomes ischemic, a host of changes occur at the cellular level that lead to a shift in transcriptional activity of many inflammatory and cytoprotective compounds, a process which is extensively controlled through a family of transcription factors known as nuclear factor kappa-B (NF-kappaB). This shift in activity paradoxically results in both a cytoprotective effect at the cellular level and upon reperfusion, a generally destructive inflammatory response, a phenomenon referred to as ischemia reperfusion (IR) injury. To date, a number of methods of modifying the activity of NF-kappaB through either physiologic or pharmacologic manipulation have been developed and studied in animal models of IR injury and in some cases in human clinical trials.
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