His Bundle Pacing in Left Bundle Branch Block
摘要
His bundle pacing (HBP) represents a physiological pacing strategy capable of correcting left bundle branch block (LBBB) and restoring synchronous ventricular activation. This case describes successful LBBB correction through HBP guided by unipolar electrogram mapping and monitoring of the current of injury (COI). Threshold testing identified transitions between non-selective and selective His capture. Septal fibrosis may pose a challenge to lead fixation during LBBAP, often requiring multiple screwing attempts. Despite these challenges, His bundle pacing ensured stable electrical performance, complete LBBB correction, and preservation of physiological ventricular activation.