Key result
Safe en-masse extraction resolves late LBBP lead dislodgement at 2 years followed by successful re-implantation.
Case Report (n=1)
No
Late dislodgement of a left bundle branch pacing lead can be safely managed with en-masse extraction and re-implantation.
Answers are grounded in this paper and cite their sources.
May support safe extraction and re-do for late LBBP dislodgement; hypothesis-generating and should not yet change practice.
A 61-years-old male underwent left bundle branch pacing for nonischemic dilated cardiomyopathy with recurrent heart failure. Left bundle branch pacing (LBBP) resulted in reduction in QRS duration along with improvement in left ventricular ejection fraction (LVEF) to 64% during follow-up. Two years after implantation he had recurrence of symptoms along with decline in LVEF to 51%. Late lead dislodgement was diagnosed and re-do LBBP was planned. The lead was extracted en-masse without complication and a new 3830 lead was positioned deep inside the proximal septum to capture the left bundle. Postprocedure echocardiography showed no ventricular septal defect or damage to tricuspid leaflet.
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Ponnusamy et al. (2021) conducted a case report in Nonischemic dilated cardiomyopathy with recurrent heart failure (n=1). Left bundle branch pacing lead extraction and re-do LBBP was evaluated on Successful lead extraction and re-implantation. Late dislodgement of a left bundle branch pacing lead occurred 2 years post-implantation and was successfully extracted en-masse without complications, followed by a successful re-do LBBP.
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