Peri-left bundle branch pacing after atrioventricular node ablation and failed his bundle pacing in atrial fibrillation

Abstract

We described a case where peri-left bundle branch pacing (PLBP) may become an alternative approach in difficult His bundle pacing (HBP) following atrioventricular nodal ablation in a patient with atrial fibrillation. After atrioventricular nodal ablation, the HBP lead was removed to another LBB position distal to the first PLBP lead, due to acute threshold increase. At 3 month follow-up, PLBP exhibited acceptable pacing parameters without any adverse event.