New Conduction System Pacing Tools for Added Flexibility During Implantation

BIOTRONIK has today unveiled the newest suite of tools for the more specialized implanting procedures in the His-bundle cardiac conduction system. The company will present the tools to cardiologists this week as part of European Heart Rhythm Association’s (EHRA) online congress.

BIOTRONIK has worked closely with clinical experts in the field in the design process of its centerpiece Selectra 3D catheter. The catheter includes a portfolio of nine distinct length and curve variations and is now CE-market approved for use in His-bundle procedures. It has been designed to allow for lead placement in both the atrium and ventricle to support conduction system pacing (CSP) procedures. Unlike current industry standard, Selectra 3D has added stability and holds its shape during the potentially longer CSP procedures¹.

There has been an increasing need for more choices in His-bundle pacing tools to promote procedure success rates given the diversity in patient anatomy. The increased array of Selectra 3D catheters, which can adapt to individual patients, will give physicians more choice and control during procedures. Following an extensive, multi-phased development approach, 95 percent of users rated Selectra 3D catheters equal to or even better than other tools in the market on form stability² and 90 percent on catheter tip control; crucial during CSP procedures.

Leading CSP pacing expert, Dr. Francesco Zanon from Santa Maria della Misericordia Hospital, Italy said that a wider range of catheter choice is essential to help promote positive outcomes: “The most challenging element during conduction system procedures, is managing tool selection given patient anatomy - the right curve in the catheter is the key to success. The sector has gone through an extensive learning period in the evolution on His-bundle tools; what has been achieved with Selectra 3D will support more physicians in achieving that success – and in turn, improve clinical outcomes for patients.”

His-bundle pacing is regarded as the most physiological approach to pacing but its complexity can present a barrier to physicians. The procedure often requires more time than right-ventricular implantations and in addition, locating and placing the lead at the His-bundle, whose position differs from patient to patient, can further complicate the already intricate procedure.

The rising interest in conduction system pacing is due to the increased need for physicians to avoid the various adverse effects that have been associated with long-term right-ventricular pacing^3-6.

BIOTRONIK CSP tools are already available globally. Participating centers will have access to extensive training and implantation support to promote optimum procedure success rates.

Physicians who wish to find out more about BIOTRONIK’s CSP tools will be able to contact an expert during the EHRA Congress by visiting on BIOTRONIK’s industry page, here. The page will be accessible to registered EHRA participants until May 9.

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Disclaimer: BIOTRONIK CSP tools are not currently approved for His-bundle pacing in the United States. Content not intended for U.S. healthcare providers.

References: 

1. BIOTRONIK Initial Market Observation Summary
2. BIOTRONIK Initial Market Observation Summary
3. Tse, Hung-Fat; Lau, Chu-Pak (1997): Long-Term Effect of Right Ventricular Pacing on Myocardial Perfusion and Function. In Journal of the American Col lege of Cardiology 29 (4), pp. 744–749. DOI: 10.1016/S0735-1097(96)00586-4.
4. Sweeney, Michael O.; Hellkamp, Anne S.; Ellenbogen, Kenneth A.; Greenspon, Arnold J.; Freedman, Roger A.; Lee, Kerry L.; Lamas, Gervasio A. (2003): Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction. In Circulation 107 (23), pp. 2932–2937. DOI: 10.1161/01.CIR.0000072769.17295.B1.
5. Wilkoff, Bruce L.; Cook, James R.; Epstein, Andrew E.; Greene, H. Leon; Hallstrom, Alfred P.; Hsia, Henry et al. (2002): Dual-chamber pacing or ventricular backup pacing in patients with an implantable defibrillator. The Dual Chamber and VVI Implantable Defibrillator (DAVID) Trial. In JAMA 288 (24), pp. 3115–3123. DOI: 10.1001/jama.288.24.3115.
6. Nielsen, Jens C.; Kristensen, Lene; Andersen, Henning R.; Mortensen, Peter T.; Pedersen, Ole L.; Pedersen, Anders K. (2003): A randomized comparison of atrial and dual-chamber pacing in177 consecutive patients with sick sinus syndrome. In Journal of the American College of Cardiology 42 (4), pp. 614–623. DOI: 10.1016/S0735-1097(03)00757-5.