Fig. 1From: Loss of capture of conduction system pacemaker caused by fibrosis surrounding the lead: a case reportConduction system pacing implantation. LBB pacing lead implantation in a patient with AV-block, with electrograms during LBB pacing. The paced LV activation time is 77ms. In the middle left panel, a fluoroscopy image reveals the fulcrum sign, illustrating the pivotal point where the lead body intersects with the RV septum. Chest X-rays are presented below, in which the leads and generator are visibleBack to article page