Int J Arrhythm.  2024 Jun;25(2):9. 10.1186/s42444-024-00113-w.

The unexpected complications of the left bundle branch area pacing (LBBAP) maneuver: a case report

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo‑Daero, Seocho‑Gu, Seoul 06591, Republic of Korea

Abstract

Background
The lead of left bundle branch area pacing (LBBAP) inserted into the muscular septum will make the transvenous lead extraction (TLE) of LBBAP more challenging and because in LBBAP ventricular lead (V lead) should be inserted into the part of the septum, damage to the vessel near the lead could occur. The case reports introduced the complications of LBBAP previously introduced, but not being considered in detail.
Case presentation
The two patients (76-year-old man, 90-year-old man) with a complete atrioventricular block (CAVB) undergoing the LBBAP procedure experienced complications related to the procedure. The complications were abrupt dysfunction of V lead and damage to the septal vein in the process of the procedure, respectively. Fortu‑ nately, they were discharged without any other complications.
Conclusions
A deliberate approach for the procedure would be needed as well as successful insertion appropriate for the protocol of LBBAP. And long-term follow-up of complications should be needed.

Keyword

Atrioventricular block; Cardiac pacing; Cardiac septum; Complications
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