Key result
LBBAP with lumen-less leads can cause delayed septal perforation and severe mitral regurgitation.
Why the study?
Left bundle branch area pacing (LBBAP) is a novel pacing modality with low complication rates but unique risks including acute or delayed septal perforation.
Case Report (n=1)
This case highlights the rare but serious complication of delayed septal perforation in patients undergoing left bundle branch area pacing, which can lead to severe mitral regurgitation.
Delayed septal perforation can occur after LBBAP; this case extends awareness of the complication and leaves open questions on incidence and surveillance.
Left bundle branch area pacing (LBBAP) has arisen as an important pacing modality introduced in an effort to avoid the deleterious effects of non-physiologic ventricular activation during chronic RV pacing. While complications rates of LBBAP are low, interventricular subendocardial septal lead delivery results in unique complications including the risk of acute or delayed septal perforation.1 We present a case of delayed septal perforation in a patient undergoing LBBAP with a lumen-less Medtronic Model 3830 Select Secure MRI Conditional Bipolar Pacing lead.
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Kaye et al. (2026) conducted a case report in Delayed septal perforation during left bundle branch area pacing (n=1). Left bundle branch area pacing (LBBAP) with a lumen-less Medtronic Model 3830 Select Secure MRI Conditional Bipolar Pacing lead was evaluated. Left bundle branch area pacing with a lumen-less Medtronic Model 3830 lead can be complicated by delayed septal perforation.
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