@kaschenke @ejsmd all long leads. pt w/lbbb. ra lead first placed in rv for pacing backup.  lead then to rv. mb ii sheath w/120-degree attain select inner sheath w/5fr al1 for venogram. inner sheath advanced over al1 before removal. active fix 4798-88 quad lv lead to upper branch. 👍 https://t.co/tufmhs2iwj