{
  "abstract": "Background: Left bundle branch area pacing (LBBAP) requires delivery-sheath support for implantation and revision. Redo procedures for lead-related complications may require additional venous puncture to regain access.\n\nCase Summary: A 79-year-old man underwent LBBAP for complete atrioventricular block. Four days later, abrupt threshold elevation and loss of capture occurred. Fluoroscopy showed complete interventricular septal perforation with lead-tip migration into the left ventricular cavity. Lead revision was performed using a sheath-assisted access-preserving technique without additional venous puncture. A modified 4-F short sheath was advanced over the existing lead, allowing guidewire insertion, sheath upsizing, and successful LBBAP lead reimplantation.\n\nDiscussion: Delayed septal perforation is a rare but recognized LBBAP complication. This case demonstrates a simple technique using standard sheaths and guidewires that may reduce invasiveness during selected redo LBBAP procedures.\n\nTake-Home Message: Sheath-assisted access preservation can facilitate LBBAP lead revision without additional venous puncture.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yohei Hiruma"
    },
    {
      "affs": [
        0
      ],
      "name": "Noriaki Moriyama"
    },
    {
      "affs": [
        0
      ],
      "name": "Hikaru Tanemura"
    },
    {
      "affs": [
        0
      ],
      "name": "Kunihiko Shimizu"
    },
    {
      "affs": [
        0
      ],
      "name": "Masato Murakami"
    },
    {
      "affs": [
        0
      ],
      "name": "Shigeru Saito"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/d77pr9z520kjs.bib",
  "cited_by": 0,
  "doi": "10.1016/j.jaccas.2026.109785",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13698933/",
  "id": "d77pr9z520kjs",
  "issns": [
    "2666-0849"
  ],
  "landing_url": "https://doi.org/10.1016/j.jaccas.2026.109785",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Clinical Case"
    ],
    [
      "heading",
      "Rhythm Disorders and Electrophysiology"
    ],
    [
      "lcc",
      "RC666-701"
    ],
    [
      "openalex",
      "2705|Cardiac pacing and defibrillation studies"
    ]
  ],
  "openalex": "W7202093300",
  "pdf_url": null,
  "pmcid": "PMC13698933",
  "pmid": "42573551",
  "published": "2026-08-10",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/d77pr9z520kjs.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:38Z",
      "native_id": "PMC13698933",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.jaccas.2026.109785"
    },
    {
      "first_seen": "2026-10-30T13:43:16Z",
      "native_id": "b92dedcb68b644e886444fb1e2062062",
      "source": "doaj",
      "url": "https://doi.org/10.1016/j.jaccas.2026.109785"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Cardiac pacing and defibrillation studies",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Sheath-Assisted Redo Left Bundle Branch Area Pacing Without Additional Venous Puncture",
  "title_text": "Sheath-Assisted Redo Left Bundle Branch Area Pacing Without Additional Venous Puncture",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:43:16Z",
  "url": "https://research.draconitic.com/paper/d77pr9z520kjs",
  "venue": "JACC Case Reports",
  "versions": []
}