Left Bundle Branch Optimized Implantable Cardioverter Defibrillator (LOT-ICD) implantation in a Patient with Myotonic Dystrophy

Abstract

Left bundle branch (LBB) optimized implantable cardioverter defibrillator (LOT-ICD) is a recently emerged alternative to the standard biventricular pacing - ICD (BiVp-ICD). The IS-1 connector pin of the ICD lead was closed with a protective cap and the LBB pacing (LBBP) lead was inserted into the ICD generator at the ventricular P/S hole. Herein, we presented a myotonic dystrophy patient who underwent LOT-ICD device implantation because of a high degree of atrioventricular block and heart failure with mid-range ejection fraction. A DDD-ICD (DF-1) was implanted in our patient which has been attached to the atrial lead (RA hole), the LBBP lead (ventricular IS-1 hole), and the ICD lead (ventricular DF-1 hole). The IS-1 pin of the ICD lead was closed accordingly. The LOT-ICD should be considered an option to standard BiVp-ICD associated with lower cost, lower procedure time, and no phrenic nerve capture.