Left bundle branch area pacing guided by intracardiac echocardiography imaging

Left bundle branch area pacing (LBBAP) has been increasingly adopted for bradycardia as well as cardiac resynchronization therapy indications owing to its physiological nature. Contrast injection can help with assessing the depth of the lead in the septum and ruling out interventricular septal vascular injury. There are limited data on the use of intracardiac echocardiography (ICE) imaging in LBBAP procedures. Therefore, we aimed to assess the procedural workflow and outcomes of ICE-guided LBBAP using a venous access obtained through the device pocket for ICE imaging.