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. 2023 Oct 31;10(11):448. doi: 10.3390/jcdd10110448

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© 2023 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Patient with non-ischemic cardiomyopathy undergoing HOT-CRT. Baseline LBBB (panel (A)) could be only partially corrected with HBP (panel (B)). S-HBP without bundle branch correction could be seen at low outputs (panel (C)). Adding a CS lead and pacing from the His lead 20 ms earlier than from the CS lead, a further reduction in QRS duration could be obtained (panel (E)). Panel (D) shows the paced QRS morphology from the CS lead only. Panels (F,G) show the final lead locations in the LAO and RAO views, respectively. CS: Coronary sinus; HBED: His bundle electrogram (distal). HOT-CRT: His-Optimized cardiac resynchronization therapy. Sweep speed 25 mm/s.