A multi-lead ECG monitoring combined with a programmed intracavitary ECG to complete LBBaP pacing: study protocol for a Single-center, prospective study

Background: Left bundle branch area pacing (LBBaP) has emerged as an alternative method for delivering physiological pacing to provide a near physiological ventricular activation. However, the clinical application and promotion of LBBaP is currently largely depended on the electrophysiological multichannel recorder to record the intracardiac electrogram (EGM). It is difficult for many primary hospitals lack of relevant equipment to carry out such operations. Methods: : We aim to recruit 100 patients of bradycardia with a pacemaker indication and nomal ejection fraction(EF>50%), using multi-lead surface electrocardiogram (ECM) monitoring and pacing system analyzer(PSA), combining with the nine-zone pacing method of the LBBaP, to complete LBBaP without an electrophysiological multichannel recorder, only based on the changes of paced QRS morphology on the multi-lead ECG monitoring and the intracavitary electrocardiogram p potential seen in pacing system analyzer. After completing the lead implantation, we will assess multiple parameters to verify whether the LBBaP is successfully achieved and to judge the feasibility and effectiveness of LBBaP using this method without electrophysiological multichannel recorder. Discussion: This study will aim to demonstrate the effectiveness and feasibility to achieve LBBaP combining the multi-lead ECG monitoring and the intracavitary ECG of pacing system analyzer without electrophysiological multichannel recorder. Trial registration: This trial is registered with the Chinese Clinical Trial Registry (ChiCTR2100044845; March 30, 2021 (URL: http://www.chictr.org.cn/showproj.aspx?proj=124207).