What configuration is typically used for the HB/LB-D?

The correct configuration for HB/LB-D involves using a His-bundle (HB) or left bundle (LB) lead, a right ventricle (RV) implantable cardioverter-defibrillator (ICD) lead, and a right atrium (RA) lead. This composition allows for comprehensive pacing of the heart’s conduction system while also providing defibrillation capabilities.

The His-bundle or left bundle pacing leads enable effective stimulation of the conduction system to achieve more physiologic ventricular activation compared to traditional right ventricular pacing. By including the RV ICD lead, it ensures that the patient receives appropriate therapy in the case of dangerous arrhythmias. The RA lead allows for atrial pacing and enhances overall cardiac function by maintaining synchronization with the atrial rhythm.

In contrast, options that do not include all three lead types would not provide the same level of support for pacing and arrhythmia management, which is why they are not considered the standard approach for HB/LB-D configurations.