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. 2021 Mar 23;8:630399. doi: 10.3389/fcvm.2021.630399

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Copyright © 2021 Liu, Wang, Sun, Qin and Zheng.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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How to locate the site for LBBP and electrogram characteristics. (A) A photographic representation of LBBP. (B) Location of the HBP lead and LBBP leads in the right anterior oblique 30° view. (C) Paced morphology of “W” pattern with a notch at the nadir of the QRS in lead V1 and impedance of 300 Ω by unipolar tip pacing before fixation (left). Screwing the lead ~6–8 mm deep, the notch in lead V1 moved up and toward the end of the QRS with impedance of 650 Ω. Increased output, from 6.0 V/0.5 ms (middle) to 8.0 V/0.5 ms (right), caused the paced morphology to change to RBBB and the pLVAT to be shortened from 107 to 72 ms (9). HBP, His-bundle pacing; HB, His bundle; LBB, left bundle branch; LBBP, left bundle branch pacing; RBBB, right bundle branch block; pLVAT, peak left ventricular activation time; AVN, atrioventricular node; RBB, right bundle branch; IVS, interventricular septum.