case_images: PMC10374266_01
case_images: - Eletrocardiograma inicial, QRS 240 ms.
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case_images: PMC10374266_01_0066-782X-abc-120-07-e20220464-gf01.jpg
case_images: f01
case_images: Transthoracic echocardiogram (TTE), August/2020, showed LVEF (Simpson) of 26%, left atrial volume, 37 ml/m2, LV end-diastolic diameter, 62 mm, asynchronous septal movement, diffuse hypokinesia, inferior and inferolateral predominance, and laterobasal aneurysm; ECG showed ventricular stimulus simulating LBBB, QRS 240 ms and -60  QRS axis (Figure 1).
case_images: - Eletrodo em septo IV profundo (OAE 35 ).
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case_images: PMC10374266_01_0066-782X-abc-120-07-e20220464-gf02.jpg
case_images: f02
case_images: The end position was confirmed after infusion of iodinated contrast (Figures 2 and 3).
case_images: - Radiografia final pos-procedimento.
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case_images: PMC10374266_01_0066-782X-abc-120-07-e20220464-gf03.jpg
case_images: f03
case_images: The end position was confirmed after infusion of iodinated contrast (Figures 2 and 3).
case_images: - Eletrocardiograma pos-estimulacao septal profunda. Observa-se reducao do QRS.
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case_images: PMC10374266_01_0066-782X-abc-120-07-e20220464-gf04.jpg
case_images: f04
case_images: Final ECG: Pacemaker pacing, atrioventricular stimulation, generating QRS 125 ms, -10  axis (Figure 4).
case_images: - Ecocardiograma mostrando ponta de eletrodo septal (seta).
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case_images: PMC10374266_01_0066-782X-abc-120-07-e20220464-gf05.jpg
case_images: f05
case_images: In the first postoperative month, TTE showed LVEF (38%), left atrial volume, 30 ml/m2, LV diastolic diameter, 60 mm, systolic, 41 mm, IV septum, 8 mm, and posterior wall, 7mm, dyssynchrony reduction, maintaining alterations in contractility secondary to CCM (figure 5).