Key result
Mechanical septal debulking serves as a bailout technique enabling LBBP through dense septal scar.
Case Report
Describes a bailout technique using mechanical septal debulking to facilitate left bundle branch pacing in patients with dense septal scar.
Supports feasibility of debulking-assisted LBBP in scarred septa; leaves open efficacy and durability in larger CRT trials.
Conduction system pacing has emerged as a more physiological alternative to conventional right ventricular apical pacing and has demonstrated promising results in patients with left bundle branch block. Moreover, it is the preferred option in patients with an indication for cardiac resynchronization therapy (CRT) when coronary sinus lead implantation is not feasible or is associated with suboptimal outcomes.
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Negreira‐Caamaño et al. (2026) conducted a case report in Left bundle branch block or indication for cardiac resynchronization therapy. Mechanical septal debulking was evaluated. Mechanical septal debulking is described as a bailout technique to enable left bundle branch pacing through dense septal scar.
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