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. 2021 Mar 24;8:645947. doi: 10.3389/fcvm.2021.645947

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Copyright © 2021 Chen, Wei, Bai, Wang, Qin, Wang, Liang, Su and Ge.

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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Images of four cases with septum injury during the procedure. (A) The fluoroscopic image of a 71-year-old female having mitral regurgitation and sick sinus syndrome with ventricular septum injury (red arrow) during LBBP lead implantation at LAO 35°. (B) The fluoroscopic image of a 77-year-old male with atrial fibrillation and complete AVB with septum injury (red arrow) during LBBP lead implantation with a single-chamber pacemaker at LAO 35°. The lead was not repositioned, and its location is illustrated at PA (C), RAO30° (D), and LAO 35° (E). Fluoroscopic images of a 64-year-old male with sick sinus syndrome post-bioprosthetic tricuspid valve replacement having septum injury (red arrow) during LBBP lead implantation with a dual-chamber pacemaker at PA (F) and LAO 35° (G). The lead was not repositioned, and its location is illustrated at PA (H), RAO30° (I), and LAO 35° (J). (K) The fluoroscopic image of an 85-year-old male with complete AVB and atrial fibrillation having septum injury (red arrow) during LBBP lead implantation with a dual-chamber pacemaker at LAO 35°. The lead was not repositioned, and its location is illustrated at PA (L), RAO30° (M), and LAO 35° (N). LBBP, left bundle branch pacing; AVB, atrioventricular block; PA, posteroanterior; LAO, left anterior oblique; RAO, right anterior oblique.