Procedure technique and a rare intraprocedural complication during permanent His bundle pacing

M V Gorev,Sh G Nardaya,S V Petelko,Yu I Rachkova,F G Rzaev,O A Sergeeva

doi:10.35336/va-2021-e-54-57

Abstract

A case of successful endocardial lead implantation into the His bundle position is presented. Procedure technique and transient atrioventricular block during implantation are described.

Highlights

We present a rare case of transitional AV conduction impairment during His-bundle pacing (HBP) lead fixation in a patient with atrial fibrillation and tachy-induced cardiomyopathy
Severe heart failure status and several prothrombotic fac- interval duration during non-selective HBP was slightly tors did not longer than H-QRSend during the spontaneous conduction allow us to wait for the spontaneous lysis of the thrombus on (Fig. 2, E-G)
Lead and delivery tool lengths should be considered during the preimplantation setup

Summary

PROCEDURE TECHNIQUE AND A RARE INTRAPROCEDURAL COMPLICATION

DURING PERMANENT HIS BUNDLE PACING M.V.Gorev, Sh.G.Nardaya, S.V.Petelko, Yu.I.Rachkova, O.A.Sergeeva, F.G.Rzaev. Severe heart failure status and several prothrombotic fac- interval duration during non-selective HBP was slightly tors (low LV EF, uncontrolled high ventricular rate) did not longer than H-QRSend during the spontaneous conduction allow us to wait for the spontaneous lysis of the thrombus on (Fig. 2, E-G). In our opinion, this phenomenon could be the anticoagulant therapy. Entire His pacing lead was screwed in clockwise for more durable fixation During this manipulation, the intermittent AV block with 5-second pause and subsequent ventricular rate deceleration to 50-80 bpm was documented (Fig. 2, A).

DISCUSSION

LIMITATIONS

CONCLUSION