Electrocardiography guided left bundle branch pacing

Left bundle branch pacing is a novel technique where LBB is directly captured by placing the lead deep inside the proximal septum. Electrocardiology plays a major role in identifying the target site on the right side of the septum, monitoring the lead deployment and confirming the LBB-capture. The lead is deployed 1-1.5 cm below the His bundle along an imaginary line connecting distal His signals to right ventricular apex. Rapid deployment of the lead will generate premature ventricular complexes which will guide in reaching the left bundle branch area. Several ECG based criteria will assist in confirming the conduction system capture. Further randomized trials will help in establishing the long-term safety of this novel pacing modality.