Mechanisms of damage related to ICD and pacemaker lead interaction
Increasing acceptance of left bundle branch area pacing for cardiac resynchronization therapy raises the possibility for multiple leads in the right ventricle. The interaction between 2 leads is one of the few mechanisms that may cause damage to both insulation and conductors and could ultimately cause loss of therapy.1,2 The general guidance is to avoid contact between leads, which can be challenging. However, there is limited information about the time progression of damage and factors that may influence which lead is damaged.