Successful Left Bundle Branch Area Pacing Using the Sheath-In-Sheath Technique in a Patient With Right Atrial Enlargement and Tricuspid Annuloplasty Ring

Abstract

We report a successful LBBAP lead implantation using the sheath-in-sheath technique in a patient with RA enlargement and a TAP ring. The sheath-in-sheath technique can serve as a valuable alternative approach in patients with structural heart abnormalities in whom LBBAP lead placement with a standard delivery system is technically challenging.