Transvenous left bundle branch pacing during cardiac surgery: A case report

Key Clinical Message Left bundle branch pacing (LBBP) was a promising physiological pacing method, which could prevent or treat heart failure. We reported a young woman with severe valvular disease and heart failure receiving LBBP under direct vision and without x‐ray assistance during cardiac surgery. To the best of our knowledge, this was the first case report of this type of pace maker implantation. This was a unique case of transvenous left bundle branch pacing (LBBP) performed under direct vision during a complex heart valve surgery. Two electrodes were surgically implanted, with one placed in the region of the left bundle branch (indicated by the white arrow), and another positioned in the lower septum of the right ventricle as a backup (indicated by the black arrow). Postoperative electrocardiography confirmed successful achievement of LBBP.