Expanding the role of the clavipectoral fascial plane block: Successful dual-chamber pacemaker implantation with left bundle branch area pacing in an elderly patient

Figures

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  Figure 1. Patient’s admission electrocardiogram that reveals complete atrioventricular block.

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  Figure 2. Areas where local anesthetic agents are administered after the clavipectoral fascial plane block.

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  Figure 3. Cineangiographic still image obtained during left bundle branch area pacing lead implantation in the left anterior oblique projection. The lead’s orientation toward the interventricular septum and the intended pacing site are demonstrated (Red lines indicate the RV surface and LV surface of the interventricular septum).

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  Figure 4. Postprocedural electrocardiogram. The criteria defined in the European Heart Rhythm Association left bundle branch area pacing consensus report are fulfilled.

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  Figure 5. Illustration of the clavipectoral fascia and adjacent anatomical structures. The schematic demonstrates the relationship of the clavipectoral fascia with the pectoralis major and minor muscles, the subclavius muscle, and neighboring neurovascular elements, including the supraclavicular, lateral pectoral, and medial pectoral nerves.

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  Figure 6. Step-by-step clavipectoral fascial plane block for cardiac implantable electronic device (CIED) implantation. LA = local anesthetic; US = ultrasound.

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  Supplementary figure 1.