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

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.

Article for Discussion: Permanent Left Bundle Branch Area DF-4 Defibrillator Lead Implantation Feasibility, Procedural Caveats, Safety, and Follow-Up

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.

Podcast Contributors

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

Speaker and Article Information: Download

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