Questions and Answers
What structure is formed from a group of heart muscle cells and transmits the electrical impulses generated by the AV node to the left and right bundle branches?
How long is a normal HV interval?
35-55 ms
Reviewing safety margin and battery longevity, what output might you consider for a patient with a selective HBP threshold of 1.25V @ 1.0 ms and a non-selective HBP threshold of 1.75V @ 1.0 ms?
Which of the following are potential benefits of LBBAP? (Select all that apply)
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Which LBB capture type is defined as simultaneous capture of the LBB and local ventricular septal myocardium?
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Which LBB capture type is defined as capture of the LBB alone without capture of local myocardium?
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When the C315HIS delivery catheter is in a neutral position, the hub is? (Select all that apply)
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When the C304-HIS delivery catheter is in a neutral position, the hub is? (Select all that apply)
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When fixating the model 3830 MRI lead at the HB, how many complete turns should the lead be rotated?
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Place the HBP implant procedure steps in the correct order.
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Average septal thickness range is?
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If mapping the HB during the LBBAP procedure, approximately how many cm below the distal HB is the LBB target located?
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If the HB is not mapped or a contrast septogram is not performed, what technique(s) can be used to identify the LBB area implant target location?
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What might a significant drop in impedance or a complete loss of current of injury indicate when implanting a lead at the LBB area?
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Study Notes
Medtronic Academy Conduction System Pacing Overview
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His Bundle Defined: A structure made of heart muscle cells that transmits electrical impulses from the AV node to the bundle branches.
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Normal HV Interval: Typically ranges from 35-55 ms.
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Output Consideration for Selective HBP: For patients with a selective HBP threshold of 1.25V @ 1.0 ms and a non-selective HBP threshold of 1.75V @ 1.0 ms, a safe output is 2.5V @ 1.0 ms.
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Benefits of Left Bundle Branch Area Pacing (LBBAP):
- Stable and low stimulation thresholds.
- Wide target zone for pacing.
- Achieves left septal myocardial capture without oversensing.
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Types of LBB Capture:
- Non-selective LBBAP: Simultaneous capture of the LBB and local ventricular septal myocardium.
- Selective LBBAP: Capture of the LBB only, excluding local myocardium.
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C315HIS Delivery Catheter Position:
- In neutral position, the hub is at 6:00 and in the same plane as the distal curve.
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C304-HIS Delivery Catheter Position:
- In neutral position, the hub is at 9:00 and in the same plane as the proximal curve.
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Fixating Model 3830 MRI Lead: The lead should be rotated 4-5 complete turns for proper fixation.
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HBP Implant Procedure Steps (Correct Order):
- Select catheter
- Obtain venous access
- Prepare the EP system
- Map the HB
- Fixate the lead
- Test the HB location
- Slit the catheter
- Select the appropriate device
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Average Septal Thickness: The typical range is between 0.7-1.8 cm.
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Location of LBB Target During LBBAP: The LBB target is generally found 1-2 cm below the distal HB.
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Identifying the LBB Area Target: Techniques include the partition method and the use of a 12 lead ECG when mapping the HB or performing a contrast septogram isn't feasible.
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Significance of Impedance Drop During Lead Implantation: A major drop in impedance or loss of current may indicate a septal perforation during lead placement at the LBB area.
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Description
Test your knowledge on the conduction system of the heart with this assessment quiz. The questions cover critical concepts such as the His Bundle and normal HV intervals. Perfect for students and professionals in the field of cardiology.
