Late distal conductor fracture of the lumenless pacing lead after left bundle branch area pacing

A 75-year-old man with intermittent atrioventricular block and left ventricular dysfunction underwent successful left bundle branch area pacing after 4 attempts using the C315HIS catheter and 3830 SelectSecure lumenless lead (Medtronic, Minneapolis, MN) by premature ventricular complex–guided approach1 (Figure 1A; Online Supplemental Video 1). The unipolar pacing threshold was 0.8 V/0.5 ms with a sensed R-wave amplitude of 7 mV and a unipolar pacing impedance of 640 Ω. The delivery catheter was removed after providing lead slack in the atrium (Figure 1A).