Case report of hidden (yet visible) systolic fascicular potentials in a patient with left bundle branch block during conduction system pacing implantation.

ABSTRACT:

Background

Left bundle branch pacing (LBBP) is being increasingly adopted as a more physiological alternative to conventional pacing. At implantation, appropriate lead depth can be guided by monitoring a number of parameters, including the presence of a fascicular potential during conducted rhythm. However, in patients with left bundle branch block (LBBB), a presystolic fascicular potential is most often absent, due to upstream conduction block. We present for the first time a case where delayed fascicular potentials were visible within the ventricular electrogram (EGM) of the pacing lead.

Case summary

An 88-year-old patient with decompensated heart failure of ischaemic origin with a left ventricular ejection fraction of 0.30 and LBBB with a QRS of 180 ms was scheduled for L

SUBMITTER: Kaddour M 

PROVIDER: S-EPMC9883728 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature