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Case description : A 74-year-old man suffering from severe heart failure (NYHA III – LVEF 28%) associated with left bundle branch block (LBBB) (Figure 1(A)) and uncontrolled permanent atrial fibrillation (AF) despite optimal medical treatment was referred for His ablation and rescue physiological pacing after a first unsuccessful LV lead implantation through the coronary sinus (CS). Careful review of the occluded CS angiogram indeed revealed no side branches. Concordantly, the patient was offered a ‘rescue’ HBP procedure. Using the SelectSecure lead (model 3830) and a C315 His sheath (Both Medtronic, Inc. MN), His mapping (HV ¼ 106ms) and recruitment were easily obtained, unfortunately without LBBB correction.

This subanalysis of the Euro-CRT survey II specifically focus on Belgian practice for CRT implantation. It explores Belgian adherence with the guidelines but also benchmark CRT practice in Belgium against the other European countries. Overall, Belgian management of CRT implantation is performed with great agreement with guidelines. This report could be used to provide guidance for both practical and economical approaches.

Case 1. A 82-year-old male underwent mitral valve repair using MitraClip for secondary severe mitral regurgitation (67th consecutive case, centre 1). Just before release of the second clip, the pat...