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Case Reports
. 2024 Jan;47(1):101-105.
doi: 10.1111/pace.14710. Epub 2023 May 9.

Coronary artery complications after left bundle branch area pacing: An increasingly reported issue in the era of physiologic pacing

Andrés Di Leoni Ferrari  1 , Luís Henrique Klafke  1 , Ricardo Soccol  1 , Aníbal Pereira Abelin  2 , Ricardo Medeiros Piantá  1 , Paulo Ricardo Avancini Caramori  1 , Diego Chemello  2   3
Affiliations
Case Reports

Coronary artery complications after left bundle branch area pacing: An increasingly reported issue in the era of physiologic pacing

Andrés Di Leoni Ferrari et al. Pacing Clin Electrophysiol. 2024 Jan.

Abstract

Coronary artery lesions related to pacemaker implantation are rare complications. With the increasing adoption of the technique of permanent transseptal pacing of the left bundle branch area pacing (LBBAP), an increase in the incidence of these complications may be expected. We report two cases of coronary lesions after permanent transeptal pacing of the LBBAP: the first with a small coronary artery fistula, and the second with an extrinsic coronary compression. Both complications occurred with stylet-driven pacing leads with extendable helix. In the first case, since the shunt volume was small and no major complications were reported, the patient was treated conservatively with good outcome. The second case required lead repositioning due to acute decompensated heart failure.

Keywords: interventricular septum; left bundle branch area pacing; pacemaker; septal coronary artery fistula; septal coronary extrinsic compression.

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References

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