Key result
Deep septal lead deployment during LBBAP risks venous infringement, which guiding sheath retraction may prevent.
Why the study?
Although left bundle branch area pacing is highly successful, deep septal lead deployment can lead to less frequently encountered complications.
Case Report
During LBBAP, the guiding sheath should be pulled back from the right septum to avoid complications of septal injury with venous infringement.
Raises caution for deep septal LBBAP deployment; case report leaves open whether sheath retraction reduces injury risk.
Key Teaching Points•Though left bundle branch area pacing (LBBAP) is a highly successful technique, deep septal lead deployment sometimes causes complications that are less frequently encountered.•The diameter of the septal tunnel by lead perforation during LBBAP would be sealed after lead retraction.•The guiding sheath should be pulled back from the right septum to avoid complications of septal injury with venous infringement. •Though left bundle branch area pacing (LBBAP) is a highly successful technique, deep septal lead deployment sometimes causes complications that are less frequently encountered.•The diameter of the septal tunnel by lead perforation during LBBAP would be sealed after lead retraction.•The guiding sheath should be pulled back from the right septum to avoid complications of septal injury with venous infringement.
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Kimura et al. (2023) conducted a case report in Left bundle branch area pacing complications. Left bundle branch area pacing (LBBAP) was evaluated. Deep septal lead deployment during left bundle branch area pacing can cause septal injury with venous infringement, which may be avoided by retracting the guiding sheath.
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