[Introduction]
HBP is a more physiologic modality of pacing, a feasible and effective form for ventricular activation, however, the recognition of imperfection of HBP has led to seek for more advisable options of pacing. Permanent LBBP might be an alternative to HBP to potentially maintain left ventricular electrical synchrony with better sensing, a lower and more stable capture threshold [1,2,3] , especially in patients with infra-nodal atrioventricular block and left bundle branch block.
Atrioventricular junction region includes atrioventricular node and nearby proximal His bundle, AVNA combined with HBP are feasible, safe, and effective in patients with refractory AF [4] , however, successful case of atrioventricular junction ablation (AVJA) combined with LBBP in refractory AF with comorbidity of HCM has not been documented.
Our report exactly focuses on the feasibility of electrophysiological performance, safety and clinical effectiveness of AVJA combined with LBBP in patient with refractory AF and HCM.