Abstract

A 66-year-old lady having complete AV block with narrow QRS escape had undergone left bundle branch pacing (LBB) with 4.1-F diameter 3830 Select SecureTM pacing lead (Medtronic Inc., Minneapolis, MN, USA). The pacing lead was placed with the inter-ventricular septum, 2 cm inferior to the distal His region towards the right ventricular apex, by 5 rapid turns. During the rapid turns, an interesting phenomenon was noted [Fig. 1A & B]. What is the mechanism?

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