{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T14:02:03Z","timestamp":1771250523063,"version":"3.50.1"},"reference-count":5,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Conduction system pacing (CSP) is an alternative to right ventricular pacing, providing more physiological ventricular activation. Current guidelines recommend CSP for patients with an expected ventricular pacing burden &amp;gt;20% and mildly reduced left ventricular ejection fraction. However, consistent conduction capture is not always achieved, with success rates of around 80% in the MELOS trial. Lumenless leads (LL) are widely used for CSP, but sustained, real-time pacing and impedance monitoring could enhance procedural control and decrease procedure time. The integration of a tool to overcome this limitation was highlighted as a future development in the 2025 EHRA CSP consensus. We report the first case using this approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>An 80-year-old man with paroxysmal complete atrioventricular block and mildly reduced ejection fraction underwent pacemaker implantation. CSP was selected as the pacing strategy according to current recommendations. A Medtronic\u00ae 3830 LL was delivered via a C315His sheath, connected to a Micropace\u00ae Onestim-CRM stimulator through the new rotator connector 5944RL. This configuration allowed simultaneous septal penetration and continuous pacing for real-time monitoring of current of injury and continuous impedance analysis. CSP success criteria were achieved\u2014left ventricular activation time 62\u2005ms, broad R\u2032 in V1, ventricular pacing thresholds for CSP 1.3\u2005V @ 0.4\u2005ms, fluoroscopy time 4:19\u2005min, and shorter overall procedure (skin to skin, 50\u2005min).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>To our knowledge, this case represents the first reported use of a rotatable connector for CSP lumenless lead deployment, demonstrating the feasibility of continuous pacing with LLs for CSP. Further experience is needed to confirm long-term performance and clinical impact.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag038","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:57:23Z","timestamp":1769086643000},"source":"Crossref","is-referenced-by-count":0,"title":["Conduction system pacing using a rotatable connector enabling continuous pacing during lumenless lead deployment: a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3175-3673","authenticated-orcid":false,"given":"Fernando","family":"Montenegro S\u00e1","sequence":"first","affiliation":[{"name":"Cardiology Department, Hospital Pedro Hispano , ULS Matosinhos, Senhora da Hora 4464-513 ,","place":["Portugal"]}]},{"given":"Alexandra","family":"Castro","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Pedro Hispano , ULS Matosinhos, Senhora da Hora 4464-513 ,","place":["Portugal"]}]},{"given":"S\u00f3nia","family":"Pereira","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Pedro Hispano , ULS Matosinhos, Senhora da Hora 4464-513 ,","place":["Portugal"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2553-8264","authenticated-orcid":false,"given":"Cristina","family":"Gavina","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Pedro Hispano , ULS Matosinhos, Senhora da Hora 4464-513 ,","place":["Portugal"]}]}],"member":"286","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"2026021608015974500_ytag038-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":"2026021608015974500_ytag038-B2","doi-asserted-by":"crossref","first-page":"2491","DOI":"10.1016\/j.jacep.2024.09.014","article-title":"Insights into left bundle branch area pacing: important lessons learned","volume":"10","author":"Ellenbogen","year":"2024","journal-title":"JACC Clin Electrophysiol"},{"key":"2026021608015974500_ytag038-B3","doi-asserted-by":"crossref","first-page":"euaf050","DOI":"10.1093\/europace\/euaf050","article-title":"European Society of Cardiology (ESC) clinical consensus statement on indications for conduction system pacing, with special contribution of the European Heart Rhythm Association of the ESC and endorsed by the Asia Pacific Heart Rhythm Society, the Canadian Heart Rhythm Society, the Heart Rhythm Society, and the Latin American Heart Rhythm Society","volume":"27","author":"Glikson","year":"2025","journal-title":"EP Europace"},{"key":"2026021608015974500_ytag038-B4","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s12471-022-01679-7","article-title":"A single-centre prospective evaluation of left bundle branch area pacemaker implantation characteristics","volume":"30","author":"Heckman","year":"2022","journal-title":"Neth Heart J"},{"key":"2026021608015974500_ytag038-B5","doi-asserted-by":"crossref","first-page":"ytae106","DOI":"10.1093\/ehjcr\/ytae106","article-title":"Inadvertent septal perforation during conduction system pacing device implant: a case report","volume":"8","author":"Shtembari","year":"2024","journal-title":"Eur Heart J Case Rep"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytag038\/66725156\/ytag038.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/2\/ytag038\/66725156\/ytag038.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/10\/2\/ytag038\/66725156\/ytag038.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T13:02:07Z","timestamp":1771246927000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytag038\/8456234"}},"subtitle":[],"editor":[{"given":"Felix","family":"Wiedmann","sequence":"additional","affiliation":[]},{"given":"Armen","family":"Kocharian","sequence":"additional","affiliation":[]},{"given":"Vera","family":"Maslova","sequence":"additional","affiliation":[]},{"given":"Deepti","family":"Ranganathan","sequence":"additional","affiliation":[]}],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":5,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytag038","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2]]},"published":{"date-parts":[[2026,2]]},"article-number":"ytag038"}}