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. 2021 Mar 23;8:630399. doi: 10.3389/fcvm.2021.630399

Figure 5.

Figure 5

A demonstration of direct LBB capture using retrograde His potential and anterograde distal left conduction system potential. (A) A case with narrow QRS wave. There is a small PoLBB and long pLVAT (90 ms) with septal pacing (first two beats). When the lead is advanced at a deeper site of septum, the non-selective and selective LBBP (last three beats) are visible, with larger PoLBB, shorter and constant pLVAT (74 ms), and PoRehis with stimulus to PoRehis interval of 28 ms at low and high outputs. (B) The PodLBB can be recorded after the ventricular EGM with MCP distal to the LBBP lead (first beat). The second beat shows the PodLBB remains after the ventricular EGM with 121 ms pLVAT during septal pacing, whereas the last indicates achievement of selective LBBP at a deeper site, PodLBB recorded ahead of ventricular EGM with shorter pLVAT (90 ms) (9). LBB, left bundle branch; pLVAT, peak left ventricular activation time; LBBP, left bundle branch pacing; MCP, multipolar placed; EGM, electrogram; PodLBB, distal left bundle branch potential; PoRehis, retrograde His potential.