His-bundle Pacing from the Right Atrium: Solving Pacemaker Implantation Challenges Post-TriClip

Introduction: This case report highlights the novel role of His-bundle pacing (HBP) from right atrium, not just for preserving cardiac function, but also for avoiding interference with TriClip devices.

Methods And Results: A 78-year-old female with severe tricuspid regurgitation received two TriClip devices. Postprocedure, frequent significant sinus pauses required a pacemaker. HBP was chosen to avoid lead complications. Under local anesthesia, a His pacing lead was inserted via the axillary vein using specialized catheter. Follow-ups over 2.5 years showed stable parameters with no complications.

Conclusion: HBP is effective for patients with TriClip devices, ensuring optimal cardiac function and lead stability.