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High‐density mapping‐guided corrective HIS bundle pacing after failed CRT upgrade for persistent left superior vena cava
Author(s) -
Bastian Dirk,
Buia Veronica,
Walaschek Janusch,
De Quattro Eugenio,
Rittger Harald,
VitaliSerdoz Laura
Publication year - 2020
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13931
Subject(s) - medicine , cardiac resynchronization therapy , left bundle branch block , cardiology , persistent left superior vena cava , ventricular pacing , heart block , permanent pacemaker , heart failure , electrocardiography , coronary sinus , ejection fraction
In patients with persistent left superior vena cava (PLSVC), transvenous device implantation for cardiac resynchronization therapy (CRT) may be challenging. We present a complex case with successful, high‐density electroanatomic mapping (EAM) guided corrective His bundle pacing (CHBP) following failed CRT upgrade in a patient with PLSVC, congenital heart disease, and pacing‐associated heart failure. CHBP restored physiological conduction in left bundle branch block with complete conduction block leading to clinical improvement and cardiac remodeling. The presented case supports the growing evidence that EAM‐guided CHBP may be considered a feasible alternative to conventional CRT when venous anatomy is not favorable for left ventricular lead implantation.