Deep Septal Perforation During Left Bundle Branch Area Pacing Resulting in Left Ventricular Capture and Delayed Systemic Embolism

Conduction system pacing is increasing as it allows a close to normal left ventricular stimulation using a single lead implanted in the His or left bundle branch (LBB) area; a chronic perforation with protrusion into the left ventricle was found several months after implant, with peripheral embolization. Safe retrieval was possible, despite debris attached to the lead distal tip, using a cerebral embolic protection device.