Abstract
Left bundle branch area pacing (LBBAP) is a promising pacing technique aimed at mitigating pacing-induced cardiomyopathy; however, a gap in understanding persists concerning intraprocedural complications and their management. This case study sheds light on a rare complication associated with LBBAP. Through sheath penetration into the interventricular septum at a typical site, a septogram revealed the dissection of a large septal coronary vein. Herein, we propose the management strategy and its outcome.