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\begin{document}

\title{Feasibility and Safety of Zero-Fluoroscopy Left Bundle Branch Pacing: An
Initial Experience.}



\author[1]{Javier Ramos}%
\author[1]{Jorge Melero Polo}%
\author[1]{Isabel Montilla-Padilla}%
\author[1]{Jose Ramón Ruiz Arroyo}%
\author[1]{Mercedes Cabrera}%
\affil[1]{Hospital Clinico Universitario Lozano Blesa}%


\vspace{-1em}



  
  \date{May 24, 2024}


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\begin{abstract}
\textbf{Introduction} Left bundle branch pacing (LBBP) has emerged in
recent years as a new pacing modality, providing patients with a
narrower paced QRS than conventional pacing and stable pacing
parameters. At the same time, there is a growing concern about the use
of fluoroscopy in pacemaker implantations, given its harmful effects to
both patients and operators. However, there are no prior experiences of
zero fluoroscopy in LBBP procedure. \textbf{Methods} We conducted an
observational prospective study recruiting consecutive patients that
underwent zero fluoroscopy LBBP pacemaker implantation. A 6-month
follow-up visit was programmed for every patient. The main goal of our
study was to assess the efficacy, feasibility and safety of the
procedure. \textbf{Results} From January 2021 to February 2022, we
included 10 patients, 8 males. The average age was 63 \selectlanguage{ngerman}± 4 years. The
procedure was successful in all patients. We observed a significant
reduction in paced QRS width compared with basal QRS width (149 ms vs
116 ms, p= 0.02). All device parameters remained stable at 6-month
follow-up: no significant differences in mean impedance (700.5 vs 494
Ohm, p=0.09), capture threshold (0.67 vs 0.83V @ 0.4ms, p=0.27) or
R-wave amplitude (10.6 vs 13.92 mV, p= 0.19). No complications were
reported in any case. \textbf{Conclusion} Zero fluoroscopy LBBP is
feasible and safe, and it may be considered an optimal election in cases
where radiation exposure is contraindicated or especially undesirable
and as an alternative in all other cases.%
\end{abstract}\selectlanguage{ngerman}%



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