Coronary artery complications after left bundle branch area pacing: An increasingly reported issue in the era of physiologic pacing.
Andrés Di Leoni FerrariLuís Henrique KlafkeRicardo SoccolAníbal Pereira AbelinRicardo Medeiros PiantáPaulo Ricardo Avancini CaramoriDiego ChemelloPublished in: Pacing and clinical electrophysiology : PACE (2023)
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.
Keyphrases
- coronary artery
- cardiac resynchronization therapy
- heart failure
- pulmonary artery
- risk factors
- left ventricular
- coronary artery disease
- liver failure
- hepatitis b virus
- intensive care unit
- drug induced
- atrial fibrillation
- pulmonary hypertension
- aortic dissection
- pulmonary arterial hypertension
- respiratory failure
- case report