Late Fracture of Stylet-driven Lead Intended for Conduction System Pacing 2 Years After Implant

Left bundle branch area pacing (LBBAP) has become adopted in recent years to achieve improved ventricular synchrony and reduce the risk of pacing-induced cardiomyopathy. It is a potential alternative to standard right ventricular pacing. However, long-term clinical data regarding lead integrity and longevity are still lacking. Several case reports have highlighted the risk of distal conductor lead failure. In this case, we report late distal lead conductor failure with the Solia S60 lead (Biotronik, Berlin, Germany) intended for left bundle branch area two years after initial implant.