Key result
Zero-fluoro LBBP safely treats atrial standstill in a pregnant patient with no complications at 6 months.
Why the study?
A pregnant patient with symptomatic atrial standstill and pacing indications faced a high expected ventricular pacing ratio and potential pacing-induced cardiomyopathy.
Case Report (n=1)
No
Zero-fluoroscopy left bundle branch pacing using electroanatomic mapping and intracardiac echocardiography is a feasible and safe pacing strategy for pregnant patients to avoid radiation exposure.
May enable radiation-free pacing in pregnancy; hypothesis-generating case report requiring prospective validation before broader use.
A pregnant patient had symptomatic atrial standstill and indications for pacing therapy with an expected high ventricular pacing ratio. With the consideration of potential pacing-induced cardiomyopathy in the future we conducted zero-fluoro left bundle branch pacing (zLBBP) implantation for heart failure prevention. An ex vivo 3D cardiac model (Medtronic, USA) was used preoperatively to simulate the zLBBP implantation to improve procedure safety and efficiency. Intraoperatively, the simulation steps were followed, and a combination of electroanatomic navigation systems (EANS) and intracardiac echocariography (ICE) were used to ensure that the procedure was performed efficiently and safely.
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Li et al. (2023) conducted a case report in Symptomatic atrial standstill (n=1). Zero-fluoro left bundle branch pacing (zLBBP) was evaluated on Safety and feasibility of zLBBP implantation (absence of complications). Zero-fluoro left bundle branch pacing was safely and successfully implanted in a pregnant patient with atrial standstill, with no complications observed over 6 months of follow-up.
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