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Updated: Jul 13, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Early repolarization associated with accelerated atrioventricular conduction (short PR interval) and incomplete right
1Mount Sinai School of Medicine of the New York University, New York, NY, USA. madiasj@nychhc.org
Abstract:
A 36-year-old male patient, who was admitted with atypical chest pain and had normal physical examination and laboratory findings, including on an echocardiogram and a maximal exercise treadmill/thallium test, is described. His electrocardiograms (ECGs) revealed ST-segment elevation in leads V(1) through V(1), suggestive of early repolarization variant (ERPV); in addition, there was evidence of accelerated atrioventricular conduction (short PR interval) and incomplete right bundle branch block (IRBBB). It is postulated that these 2 features represent ECG "correlates" of ERPV, which is characterized by accelerated repolarization and depolarization, and are due to a rapid conduction through all or some component(s) of the atria/AV-node/Hiss bundle/left bundle branch/left ventricle "chain," leading to a short PR interval and early and accelerated activation of the left ventricle, with resultant IRBBB. In addition to this being a case report, it constitutes a speculation that all the noted ECG findings are related and occurred in the context of ERPV; in all scientific fairness, it is possible that the accelerated atrioventricular conduction and IRBBB could have also occurred in a patient who happened to have ERPV. Finally, the occasional occurrence of morbidity and mortality in a patient with ERPV does not mitigate (at least until we know more) the time-honored belief that the ERPV is, after all, a benign ECG variant.
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