The Why and How of Selecting an ICD Lead and Location - 2020 Quality Summit presentation (Non-CE)-The Why and How of Selecting an ICD Lead and Location

Video Transcription

Video Summary

In this video, Ben Steinberg discusses the selection and location of leads for patients who are candidates for defibrillators or cardiac resynchronization therapy devices. He explains that instead of talking about ICD leads, he will focus on the pacing leads that may be added or part of systems in patients undergoing ICD device implant. Steinberg discloses his affiliations with different companies and organizations that support his work. He reviews the native intrinsic conduction system of the heart and the different pacing technologies used to achieve similar results. He explains that cardiac resynchronization therapy (CRT) has been widely adopted and implemented but has limitations related to coronary sinus anatomy, lead deployment, and underlying myocardium. Steinberg then introduces two alternative resynchronization approaches: His bundle pacing and left bundle branch pacing. He discusses the potential outcomes and long-term data related to these pacing approaches. He presents studies comparing His bundle pacing and classic CRT, as well as left bundle branch pacing and classic CRT. He concludes by suggesting that the decision of which pacing approach to use is driven by factors such as patient anatomy, disease characteristics, hardware availability, and operator expertise. He emphasizes the need for more data and device development to make physiological pacing technologies more widely available. The video was presented at the ACC Quality Summit, with credits given to Ben Steinberg for the presentation.

Keywords

ICD leads

pacing leads

cardiac resynchronization therapy

His bundle pacing

left bundle branch pacing

long-term data

physiological pacing technologies