Key result
Left bundle branch pacing via deep septal lead implantation may overcome atrioventricular blocks and bundle branch blocks not amenable to His bundle pacing.
Why the study?
Permanent His bundle pacing may require high outputs to correct conduction delay in patients with distal His bundle disease, and left bundle branch pacing may overcome blocks not amenable to His bundle pacing.
Does left bundle branch pacing overcome atrioventricular blocks not amenable to His bundle pacing in patients with distal His bundle disease?
Case Report
Does left bundle branch pacing overcome atrioventricular blocks not amenable to His bundle pacing in patients with distal His bundle disease?
Left bundle branch pacing may serve as an effective alternative for patients with infranodal AV block where His bundle pacing requires high outputs or is ineffective.
May offer rescue option when His pacing fails; leaves open need for prospective validation.
Key Teaching Points•Infranodal atrioventricular block is often due to conduction disease at the level of the main His bundle.•Permanent His bundle pacing may require high outputs to correct the conduction delay in many patients with distal His bundle disease.•Left bundle branch pacing by means of deep septal lead implantation may overcome atrioventricular blocks and bundle branch blocks not amenable to His bundle pacing.•Unipolar pacing from the lead tip and ring and bipolar pacing demonstrated the electrophysiological characteristics of pacing the left bundle branch region. •Infranodal atrioventricular block is often due to conduction disease at the level of the main His bundle.•Permanent His bundle pacing may require high outputs to correct the conduction delay in many patients with distal His bundle disease.•Left bundle branch pacing by means of deep septal lead implantation may overcome atrioventricular blocks and bundle branch blocks not amenable to His bundle pacing.•Unipolar pacing from the lead tip and ring and bipolar pacing demonstrated the electrophysiological characteristics of pacing the left bundle branch region.
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Vijayaraman et al. (2019) conducted a case report in Atrioventricular block at the distal His bundle. Left bundle branch pacing was evaluated. Left bundle branch pacing via deep septal lead implantation may overcome atrioventricular blocks and bundle branch blocks not amenable to His bundle pacing.
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