Sheath withdrawal during left bundle branch area pacing represents a mechanically vulnerable phase that can amplify axial force transmission, increasing the risk of septal perforation.
Attention to atrial geometry and sheath orientation during early sheath withdrawal in LBBAP may help reduce the risk of lead destabilization and septal perforation.
Sheath withdrawal during LBBAP may represent a mechanically vulnerable phase during which geometric constraint and sheath orientation can synergistically amplify axial force transmission to the lead tip. Recognition of this vulnerable phase, together with attention to atrial geometry and sheath orientation during early withdrawal, may help reduce the risk of lead destabilization or overt interventricular septal perforation during LBBAP.
Ohta et al. (Sun,) conducted a other in Left Bundle Branch Area Pacing (LBBAP). Sheath withdrawal during LBBAP was evaluated on Lead destabilization or interventricular septal perforation. Sheath withdrawal during left bundle branch area pacing represents a mechanically vulnerable phase that can amplify axial force transmission, increasing the risk of septal perforation.