The Lead Episode 125: A Discussion of Permanent Left Bundle Branch Area DF-4 Defibrillator Lead Implantation Feasibility, Procedural Caveats, Safety, and Follow-Up, LIVE at HRX

Description

Join host and HRS Digital Education Committee Chair Michael S. Lloyd, MD, FHRS and his guests Miguel A. Leal, MD, FHRS, and Jason T. Jacobson, MD, FHRS, live at HRX 2025.

In this prospective series of 12 device-naïve patients (median LVEF ~30%), the authors attempted permanent implantation of a single-coil DF-4 ICD lead into the left bundle branch area (LBBA). They achieved successful implantation with adequate sensing and pacing in 75% of patients, and during short-term follow-up the lead and RV parameters remained stable; minor complications occurred in ~25% of patients (lead micro-dislodgment and septal perforations). The authors conclude that LBBA ICD lead implantation is feasible with current tools and acceptable short-term outcomes, but note the higher-than-expected minor complication rate and emphasize the need for dedicated toolkits, higher operator volume, and a procedural learning curve.

Learning Objectives

• Describe the procedural feasibility, safety considerations, and short-term outcomes associated with left bundle branch area (LBBA) DF-4 defibrillator lead implantation.
• Identify key technical caveats and patient selection factors relevant to adopting this emerging pacing strategy in clinical practice.

Article Information

Permanent Left Budnle Branch Area DF-4 Debibrillator Lead Implantation Feasibility, Procedural Caveats, Safety, and Follow-Up

Article Authors

Anindya Ghosh, Chenni S. Sriram, Nibin Manu, Mullasari Ajit Sankaradas, Gaurav M. Upadhyay, Ulhas M. Pandurangi

Podcast Contributors

Michael S. Lloyd, MD, FHRS
Jason T. Jacobson, MD, FHRS
Miguel A. Leal, MD, FHRS

All relevant financial relationships have been mitigated.

Host Disclosure(s):

M. Lloyd

•Speaking/Teaching/Consulting: Medtronic, Arga Medtech, Circa Scientific
•Membership on Advisory Committees: Boston Scientific

​Contributor Disclosure(s):

J. Jacobson

•Stocks, Privately Held: Atlas 5D •Honoraria/Speaking/Teaching/Consulting: Zoll Medical Corporation, Vektor Medical, Inc. •Research: Abbott Medical, CardioFocus, Inc.

M. Leal

•Speaking/Teaching/Consulting: Medtronic

Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner):

S. Sailor: No relevant financial relationships with ineligible companies to disclose.