Arrhythmias & electrophysiology
Outcome of septal vascular injury and perforation in left bundle branch area pacing: Evaluating septal integrity using an institutional protocol
Authors' conclusion
Septal perforations are the most frequent septal complication and are easily detected. Septal vascular injuries can be detected by dedicated protocols but occur rarely. None of these complications compromised septal integrity or function.
Study context
- Population
- Adult patients receiving left bundle branch area pacing (LBBAP) between March 2019 and October 2024
- Participants
- 636 patients
- Outcome
- Septal complications
Methodological detailsstructured institutional protocol
- Structured institutional protocol
Main finding
As reported in the abstract
Septal complications
32
5%
Septal perforations
26
4%
Septal venous channel perforation (SVCPs)
3
0.5%
Septal coronary artery fistula (SCAFs)
3
0.5%
Further findings
Peak septal strain before and after implantation
- Before implantation
- 20.4% ± 3.6%
- After implantation
- 21.3% ± 3.3%
- P
- P = 0.16
- No significant differences
Late perforations or ventricular septal defects
- None observed
SCAF course
- SCAFs healed spontaneously
- Two
- SCAF persisted asymptomatically
- 1
Key pacing characteristics and left ventricular ejection fraction · throughout follow-up
- Remained stable
Original publication
Outcome of septal vascular injury and perforation in left bundle branch area pacing: Evaluating septal integrity using an institutional protocol. Heart Rhythm. Published 25 March 2025. doi:10.
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