PMC6126070_01
Electrocardiogram tracings at different time points. (a) Pre-transcatheter aortic valve implantation; (b) prolonged PR interval with left bundle branch block post-transcatheter aortic valve implantation; (c) post-His-bundle pacing with correction of the left bundle branch block.
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fig1
The preoperative electrocardiogram (ECG) showed sinus rhythm with a narrow QRS complex (Figure 1(a)). At the time of TAVI, the patient developed LBBB (average QRS duration of 180 ms) with a prolonged PR interval of 240 ms (Figure 1(b)). The paced QRS duration on 12 lead ECG was 125 ms consistent with nonselective HBP (para-Hisian morphology) (Figure 1(c)).
Chest X-rays (posterior-anterior and lateral views) after transcatheter aortic valve implantation and His-bundle pacemaker insertion.
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fig2
A dual-lead Boston Scientific Accolade  Extended Life DR Pacemaker was implanted via the left cephalic vein (Figure 2).