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Updated: Aug 21, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Right-Sided Dual-Chamber Left Bundle Branch Area Pacing in Persistent Left Superior Vena Cava: A Case Report on
Dhan Bahadur Shrestha1, Ashlesha Chaudhary2, Aamir Gilani1
1Division of Cardiology, Department of Internal Medicine, Bassett Medical Center, Cooperstown, New York, USA, bassett.org.
Background:
Persistent left superior vena cava (PLSVC) can complicate transvenous device implantation due to challenging venous anatomy and limited sheath support during physiologic pacing lead delivery.
Case Summary:
A woman in her mid-40s evaluated for a syncopal episode had ambulatory electrocardiography showing high-grade atrioventricular block with prolonged pauses, deemed irreversible, leading to plans for a permanent pacemaker. Intraprocedural venography identified a PLSVC. A right-sided dual chamber left bundle branch area pacing (LBBAP) was successfully performed. The procedure was uncomplicated, and follow-up with cardiology was arranged.
Discussion:
Right-sided LBBAP can be feasible and associated with positive outcomes in patients with PLSVC, and it should be considered a strong option when traditional venous routes are difficult. Early detection and adaptable pacing strategies are essential for maximizing outcomes in such patients.
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