Combination of current and new electrocardiographic-based criteria: a novel score for the discrimination of left bundle branch capture

Abstract Funding Acknowledgements Type of funding sources: None. Background Left bundle branch (LBB) area pacing (LBBAP) has been widely adopted for an increasing number antibradycardia and CRT procedures worldwide. Two different types capture have described during LBBAP: left ventricular septal myocardial (LVSP) or direct LBB via non-selective (ns)-LBB selective (s)-LBB (LBBP). Nevertheless, electrocardiographic diagnosis remains one the challenges modern conduction system pacing. Purpose We hypothesized that combination several ECG-based criteria might discriminate better LBBP from LVSP, than each criterion separately. Methods Single-center study involving all consecutive patients who received LBBAP. was defined according to QRS morphology transition decremental Multivariate logistic regression analysis performed develop a predictive score (The score), by entering three criteria: previously reported R wave peak time in lead V6 (V6-RWPT) V6-V1 interpeak interval, novel aVL-RWPT, had tested before our sample performance ROC curve analysis. The model evaluated through compared those isolated with De Long test. equation derived multivariate obtained. To simplify its clinical practice, heuristic method used score: weighted result Wald construction is depicted Figure 2. Results A total 188 intended LBBAP were screened. Successful achieved 174 (92.5%). 71 confirmed analysed score. optimal cut-off values V6-RWPT, interval aVL-RWPT discrimination <83 ms, ≥33 ms <79 respectively. showed independent not redundant predictors LBBP. AUC 0.980 differentiate LVS captures. probability can be calculated using calculation formula shown 1. differential LVSP 0.976, value 3 points (Sensitivity 89.2%, Specificity 100%) differentiation capture. Conclusions into new exhibited good power LVSP. None current such high relationship between both sensitivity specificity, so efficient precise tool implement practice.