Introducing the procedure required preparation across several stages of care. The team reviewed the steps from preoperative assessment to electrode placement and postoperative adjustments, while providing training and surgical demonstrations, according to its account of the procedure.

　　During one operation documented by the team, a local lead surgeon carried out the vein puncture, guided the wire and implanted the electrode under the Chinese specialist"s guidance. Imaging helped locate the target area, and subsequent testing confirmed that the pacing parameters met the required standards.

　　Local doctors Wesong Boko and Noah Tapaua completed structured training in the technique. Of five left bundle branch area pacing procedures reported by the team, Tapaua led three. The other two were conducted as teaching cases.

　　Those procedures formed part of 20 pacemaker implantations completed during the current team"s posting, according to its work summary.

　　The collaboration also produced a jointly developed operating manual and a care pathway covering patient screening, surgery and follow-up. These give the local team a shared reference for decisions before and after implantation.

　　Training extended to the staff supporting the procedures. On August 7, Zhang held a practical course on cardiac anatomy and pacing, bringing together cardiologists, catheterization laboratory nurses and other medical personnel.

　　Participants identified structures in anatomical specimens, practiced locating implantation sites and reviewed clinical cases. The course connected the anatomy underlying the technique with the decisions required during an actual operation.