Continuous Pacing and Recording Technique: A Real-Time Feedback Approach for Left Bundle Branch Pacing.

Left bundle branch pacing demonstrates significant clinical value in both prevention of right ventricular pacing-induced cardiomyopathy and resynchronization therapy following left bundle branch block. The current intermittent recording technique requires repeated interruptions during implantation to test parameters, increasing procedural complexity and time. In recent years, the application of stylet-driven leads and rotatable connectors combined with lumenless leads has enabled a continuous pacing and recording technique. This approach facilitates beat-by-beat monitoring of electrocardiograms and intracardiac electrograms during lead implantation, with real-time electrophysiological feedback provided to assist operators in precisely determining lead positioning and confirming left bundle branch capture. This technological innovation not only enhances procedural precision but also substantially improves operational safety. In addition, the continuous recording technique offers novel perspectives for electrophysiological research, potentially bridging cardiac pacing to advanced electrophysiological therapeutic strategies.