Giant Interventricular Septal Hematoma Complicating Left Bundle Branch Pacing

Interventricular Septal Hematoma Complicating Left Branch Bundle Lead Implantation

“…Answer: IVSH is a rare complication that has been described during interventional procedures, such as percutaneous coronary artery intervention, cardiac revascularization, after closing a ventricular septal defect, and recently a few reports after LBBP. 1 , 2 , 3 , 4 …”

“…Subsequently, after septal branch perforation, a hematoma was progressively developed. 1 , 2 , 3 , 4 …”

“…A benign evolution has been published, especially in asymptomatic cases. 3 The therapeutic approach for symptomatic patients is based on size, hemodynamic context, and etiology. Published data on successful treatment of IVSH after LBBP have described conservative conductance, 3 , 4 metallic spring coil implantation, 5 repositioning lead, 6 and coronary embolization.…”

“… 3 The therapeutic approach for symptomatic patients is based on size, hemodynamic context, and etiology. Published data on successful treatment of IVSH after LBBP have described conservative conductance, 3 , 4 metallic spring coil implantation, 5 repositioning lead, 6 and coronary embolization. 7 In this way, the treatment spectrum is wide, ranging from expected management to interventional treatment.…”

Conventional biventricular pacing is still preferred to conduction system pacing for atrioventricular block in patients with reduced ejection fraction and narrow QRS

“… 47 , 55 , 56 Rate of significant septal damage is also low, this manifests itself mainly as minor acute coronary event (0.4%) or septal haematoma (case reports only). 47 , 57 …”