Conclusion
This case report describes the occurrence of an iatrogenic
peri-membranous VSD as an unexpected complication of HBP. Routine
echocardiographic screening of the ventricular septum following pacing
lead implantation in the septum is recommended. Insights into the
incidence of VSD associated with novel pacing strategies can contribute
to the ongoing discussion which pacing site at the septum is best suited
for achieving safe and effective physiological pacing.