case_images: PMC11320998_01
case_images: (A) 12-lead ECG demonstrates sinus rhythm with RBBB without AV block. (B) 12-lead ECG demonstrates sinus rhythm with a 2:1 atrioventricular block with RBBB and prolonged AV conduction.
case_images: fcvm-11-1373884-g004.jpg
case_images: PMC11320998_01_fcvm-11-1373884-g004.jpg
case_images: F4
case_images: The ECG results showed sinus rhythm with right bundle branch block (Figure 4A). She was monitored on telemetry and was noted to have paroxysmal 2:1 AV block with ventricular rates of 30-35 bpm (Figure 4B) associated with pre-syncope.
case_images: Chest x-ray demonstrating a Medtronic Micra leadless pacemaker implant (red arrow).
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case_images: PMC11320998_01_fcvm-11-1373884-g005.jpg
case_images: F5
case_images: After careful consideration of the risks and benefits of reimplanting an LBBAP from the right chest or a leadless AV pacemaker, she underwent implantation of a leadless AV pacemaker, as shown in the chest x-ray taken the following morning (Figure 5).
case_images: PMC11320998_02
case_images: Medtronic 3830 lead with a fixed helix implanted through the RV endocardium to the LV endocardium in the mid-interventricular septum capturing the left bundle branch of the conduction system. (A) PA chest x-ray, (B) lateral chest x-ray, and (C) four-chamber transthoracic echocardiogram view of the left bundle branch pacing lead.
case_images: fcvm-11-1373884-g006.jpg
case_images: PMC11320998_02_fcvm-11-1373884-g006.jpg
case_images: F6
case_images: The chest x-ray (Figures 6A,B) and echocardiogram (Figure 6C) results demonstrated a Medtronic 3830 lead with a fixed helix implanted through the RV endocardium to the LV endocardium in the mid-interventricular septum, capturing the left bundle branch of the conduction system.
case_images: 12-lead ECGs demonstrating RV apical pacing vs. LBBAP.
case_images: fcvm-11-1373884-g007.jpg
case_images: PMC11320998_02_fcvm-11-1373884-g007.jpg
case_images: F7
case_images: The ventricular paced morphology was consistent with the left bundle branch capture, as demonstrated by a prominent terminal r' in lead V1 (Figure 7) and a V6 R wave peak time of 68 ms and as measured from the pacing stimulus to the peak of the R wave in lead V6.