Coronary Venous Visualization During Deep Septal Lead Placement: An Unexpected Finding

Syeda Atiqa Batul; Ankit Mahajan; Faiz Ali Subzposh; Wilson Young; Andrew Mathew; Parash Pokharel; Randle Storm; Jess Oren; Pugazhendhi Vijayaraman

doi:10.1016/j.jaccas.2022.08.037

Coronary Venous Visualization During Deep Septal Lead Placement: An Unexpected Finding

JACC Case Rep. 2022 Nov 3;4(24):101622. doi: 10.1016/j.jaccas.2022.08.037. eCollection 2022 Dec 21.

Authors

Syeda Atiqa Batul¹, Ankit Mahajan¹, Faiz Ali Subzposh¹, Wilson Young¹, Andrew Mathew¹, Parash Pokharel¹, Randle Storm¹, Jess Oren¹, Pugazhendhi Vijayaraman¹

Affiliation

¹ Geisinger Heart Institute, Geisinger Commonwealth School of Medicine, Wilkes-Barre, Pennsylvania, USA.

Abstract

Left bundle branch area pacing has emerged as a safe and feasible alternative to conventional pacing. Acute septal injury, septal perforation, and arteriovenous fistula are potential risks of deep septal implants. Contrast drainage through the lesser cardiac veins and subsequent filling of major epicardial vessels may be benign observations noted during forceful hand injection. (Level of Difficulty: Advanced.).

Keywords: CS, coronary sinus; HTN, hypertension; LBBAP, left bundle branch area pacing; LBBP, left bundle branch pacing; LV, left ventricular; LVEF, left ventricular ejection fraction; NS, nonselective; TTE, transthoracic echocardiography; cardiac pacemaker; coronary circulation; left ventricle; pLVAT, peak left ventricular activation time; x-ray fluoroscopy.

Publication types

Case Reports