Bailout Deep Septal LV Pacing to Treat Inadvertent Complete AV Block During Complex Ablation Procedure

Area of Science:

• Cardiology
• Electrophysiology
• Heart Failure Management

Background:

• Radiofrequency ablation is a standard treatment for symptomatic premature ventricular contractions.
• Complex heart failure patients present unique challenges during electrophysiologic procedures.
• Atrioventricular block is a potential complication during ablation procedures.

Observation:

• A case of persistent complete atrioventricular block was observed during the diagnostic phase of premature ventricular contractions ablation.
• The patient had a history of complex heart failure.

Findings:

• Successful management of the atrioventricular block was achieved using bailout deep left ventricular septal pacing.
• Bipolar radiofrequency ablation successfully eliminated the premature ventricular contractions.

Implications:

• Deep left ventricular septal pacing can be an effective bailout strategy for atrioventricular block during premature ventricular contractions ablation.
• This case highlights the importance of tailored pacing strategies in complex heart failure patients undergoing ablation.
• Careful patient selection and procedural monitoring are crucial in high-risk populations.