Lead Integrity and Failure Evaluation in Left Bundle Branch Area Pacing (LIFE-LBBAP) Study.

Background: Left bundle branch area pacing (LBBAP) has gained increased adoption globally with the use of both lumenless leads (LLLs) and stylet-driven leads (SDLs). As these leads have been developed for conventional endocardial pacing sites, concerns remain regarding the lead integrity with LBBAP.

Objectives: This study evaluates lead integrity of pacing leads used for LBBAP in a large, real-world cohort of patients with LBBAP.

ZBTB18 regulates cytokine expression and affects microglia/macrophage recruitment and commitment in glioblastoma.

Glioma associated macrophages/microglia (GAMs) play an important role in glioblastoma (GBM) progression, due to their massive recruitment to the tumor site and polarization to a tumor promoting phenotype. GAMs secrete a variety of cytokines, which facilitate tumor cell growth and invasion, and prevent other immune cells from mounting an immune response against the tumor. Here, we demonstrate that zinc finger and BTB containing domain 18 (ZBTB18), a transcriptional repressor with tumor suppressive function in glioblastoma, impairs the production of key cytokines, which function as chemoattractant for GAMs.

Stylet-driven Leads or Lumenless Leads for Conduction System Pacing.

Stylet-driven leads have been recently introduced for conduction system pacing, while most of the previous experience has been obtained with lumenless leads. Design and structural characteristics of both lead types are significantly different, resulting in different implant techniques and independent learning curves. Lead performance appears to be comparable, whereas data on direct comparison of clinical outcomes are scarce.

Conduction system pacing compared with biventricular pacing for cardiac resynchronization therapy in patients with heart failure and mildly reduced left ventricular ejection fraction: Results from International Collaborative LBBAP Study (I-CLAS) Group.

Background: Cardiac resynchronization therapy (CRT) is a guideline-recommended therapy in patients with heart failure with mildly reduced ejection fraction (HFmrEF, 36%-50%) and left bundle branch block or indication for ventricular pacing. Conduction system pacing (CSP) using left bundle branch area pacing or His bundle pacing has been shown to be a safe and physiologic alternative to biventricular pacing (BVP).

Objective: The aim of this study was to compare the clinical outcomes between BVP and CSP for patients with HFmrEF undergoing CRT.

Acute myocardial infarction in a patient with permanent left bundle branch pacing.

Background: Electrocardiographic diagnosis of acute myocardial infarction in the setting of cardiac pacing represents diagnostic challenge. There are no focusing data, neither reporting about diagnostic sensitivity of 12‑lead ECG with left bundle branch area pacing (LBBAP) during acute myocardial infarction (AMI).

Case Summary: We present 12‑lead ECG morphology in a patient with permanent LBBAP during AMI.