Are three-dimensional mapping systems useful for left bundle branch area pacing?

Key Teaching Points•The use of KODEX-EP 3D mapping system (EPD Solutions, Philips, Best, The Netherlands) in left bundle branch area pacing procedures can lead to successful and safe implantation with very low fluoroscopy. This approach can reduce the radiation exposure for patients and medical personnel.•The 3D reconstruction of the right ventricle can facilitate the identification of the target region before pace mapping and lead screwing. This approach allows for real-time assessment of the position and depth of the lead within the septum, which can help to minimize the risk of complications.•The anatomic approach enabled by the 3D reconstruction may have the potential to reduce the learning curve for implanters with limited experience in left bundle branch area pacing and lower the risk of complications. By providing a clear visualization of the anatomy, the system may help new implanters to more easily and accurately navigate the catheter. •The use of KODEX-EP 3D mapping system (EPD Solutions, Philips, Best, The Netherlands) in left bundle branch area pacing procedures can lead to successful and safe implantation with very low fluoroscopy. This approach can reduce the radiation exposure for patients and medical personnel.•The 3D reconstruction of the right ventricle can facilitate the identification of the target region before pace mapping and lead screwing. This approach allows for real-time assessment of the position and depth of the lead within the septum, which can help to minimize the risk of complications.•The anatomic approach enabled by the 3D reconstruction may have the potential to reduce the learning curve for implanters with limited experience in left bundle branch area pacing and lower the risk of complications. By providing a clear visualization of the anatomy, the system may help new implanters to more easily and accurately navigate the catheter.