Key result
Left posterior fascicular pacing successfully captured the conduction system and maintained stable pacing parameters without recurrent syncope at 3 months after failed left bundle branch pacing.
Why the study?
Left bundle branch pacing can fail, and alternative pacing techniques such as left posterior fascicular pacing warrant investigation.
Case Report (n=1)
No
Left posterior fascicular pacing is a feasible alternative technique for conduction system pacing when attempts to deploy left bundle branch pacing fail.
Left bundle branch pacing (LBBP) is emerging as an alternative to His bundle pacing that overcomes the latter's limitations. Several studies have reported on the safety, efficacy, and electrophysiological properties of LBBP, while postoperative success rates range from 80.5% to 94%. The left posterior fascicle is composed of broad bands of fibers coursing inferiorly and posteriorly toward the papillary muscle, while the anterior fascicle is a thin, tendon-like structure. We report a case of a 70-year-old man in whom left posterior fascicular pacing was done after LBBP failed. We were able to demonstrate all the features of left posterior fascicular capture, including fascicular potential and a left anterior hemiblock pattern, using surface 12-lead electrocardiography. Left posterior fascicular pacing could be an alternative technique when attempts to deploy LBBP fail.
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Ponnusamy et al. (2021) conducted a case report in Symptomatic sinus node dysfunction (n=1). Left posterior fascicular pacing was evaluated on Successful capture of the left posterior fascicle and stable pacing parameters. Left posterior fascicular pacing successfully captured the conduction system and maintained stable pacing parameters without recurrent syncope at 3 months after failed left bundle branch pacing.
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