{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T19:07:11Z","timestamp":1771268831018,"version":"3.50.1"},"reference-count":8,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T00:00:00Z","timestamp":1708992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>There has been recent growing interest in the use of conduction system pacing (CSP) for both bradycardia and heart failure indications. There remains a paucity of data, however, regarding complications related to the intraventricular septum associated with CSP implant and the management of these events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We present a case of a patient with non-ischemic dilated cardiomyopathy presenting for cardiac resynchronization therapy in whom left bundle branch area pacing was complicated with interventricular septal perforation and managed intra-procedurally with repositioning of the lead to provide His bundle pacing (HBP) for QRS correction of underlying left bundle branch block. Post-procedure echocardiography did not show persistent ventricular septal defect. Left ventricular ejection fraction improved from 13% four months before implant to 30% at 32 months post-implant. Corrective HBP pacing thresholds showed a rise at 3-year follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Interventricular septal perforation during CSP is a possible complication during lead fixation. Pre-operative septal assessment with imaging can be helpful to provide important septal anatomical features. Septal perforation can be managed appropriately with lead repositioning intra-procedurally and close follow-up.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytae106","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T20:41:10Z","timestamp":1709066470000},"source":"Crossref","is-referenced-by-count":4,"title":["Inadvertent septal perforation during conduction system pacing device implant: a case report"],"prefix":"10.1093","volume":"8","author":[{"given":"Jurgen","family":"Shtembari","sequence":"first","affiliation":[{"name":"The University of Chicago Medicine, Center for Arrhythmia Care, Section of Cardiology, University of Chicago Pritzker School of Medicine , Chicago, IL , USA"},{"name":"Department of Internal Medicine, Mount Sinai Hospital , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8121-083X","authenticated-orcid":false,"given":"Dhan Bahadur","family":"Shrestha","sequence":"additional","affiliation":[{"name":"The University of Chicago Medicine, Center for Arrhythmia Care, Section of Cardiology, University of Chicago Pritzker School of Medicine , Chicago, IL , USA"},{"name":"Department of Internal Medicine, Mount Sinai Hospital , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8513-1303","authenticated-orcid":false,"given":"Roderick","family":"Tung","sequence":"additional","affiliation":[{"name":"The University of Chicago Medicine, Center for Arrhythmia Care, Section of Cardiology, University of Chicago Pritzker School of Medicine , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3493-2100","authenticated-orcid":false,"given":"Gaurav A","family":"Upadhyay","sequence":"additional","affiliation":[{"name":"The University of Chicago Medicine, Center for Arrhythmia Care, Section of Cardiology, University of Chicago Pritzker School of Medicine , Chicago, IL , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,2,27]]},"reference":[{"key":"2024031815004695100_ytae106-B1","doi-asserted-by":"crossref","first-page":"4161","DOI":"10.1093\/eurheartj\/ehac445","article-title":"Left bundle branch area pacing outcomes: the multicentre European MELOS study","volume":"43","author":"Jastrz\u0119bski","year":"2022","journal-title":"Eur Heart J"},{"key":"2024031815004695100_ytae106-B2","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1016\/j.hrthm.2019.05.011","article-title":"Prospective evaluation of feasibility and electrophysiologic and echocardiographic characteristics of left bundle branch area pacing","volume":"16","author":"Vijayaraman","year":"2019","journal-title":"Heart Rhythm"},{"key":"2024031815004695100_ytae106-B3","first-page":"195","article-title":"Procedure-related complications of left bundle branch pacing: a single-center experience","volume":"8","author":"Chen","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"2024031815004695100_ytae106-B4","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1016\/j.hrthm.2022.01.018","article-title":"Electrophysiological characteristics of septal perforation during left bundle branch pacing","volume":"19","author":"Ponnusamy","year":"2022","journal-title":"Heart Rhythm"},{"key":"2024031815004695100_ytae106-B5","doi-asserted-by":"crossref","first-page":"e13002","DOI":"10.1111\/anec.13002","article-title":"Occurrence of ventricular septal perforation in patients with permanent left bundle branch pacing followed up using echocardiographic and computed tomography images","volume":"27","author":"Li","year":"2022","journal-title":"Ann Noninvasive Electrocardiol"},{"key":"2024031815004695100_ytae106-B6","doi-asserted-by":"crossref","first-page":"1876","DOI":"10.1161\/CIRCULATIONAHA.118.038648","article-title":"Intracardiac delineation of septal conduction in left bundle-branch block patterns: mechanistic evidence of left intrahisian block circumvented by his bundle pacing","volume":"139","author":"Upadhyay","year":"2019","journal-title":"Circulation"},{"key":"2024031815004695100_ytae106-B7","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/j.hrcr.2020.06.008","article-title":"Late-onset interventricular septal perforation from left bundle branch pacing","volume":"6","author":"Ravi","year":"2020","journal-title":"HeartRhythm Case Rep"},{"key":"2024031815004695100_ytae106-B8","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1093\/ehjci\/jex325","article-title":"Timing of myocardial shortening determines left ventricular regional myocardial work and regional remodelling in hearts with conduction delays","volume":"19","author":"Cvijic","year":"2018","journal-title":"Eur Heart J Cardiovasc Imaging"}],"container-title":["European Heart Journal - 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