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Reversal of left bundle branch block-induced cardiomyopathy by His bundle pacing

Fei Liu1, Lijun Zeng2, Xiaomeng Yin1

  • 1Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China.

The Journal of International Medical Research
|November 5, 2019
PubMed

Insights

Severe nonischemic dilated cardiomyopathy may stem from left bundle branch block (LBBB). His bundle pacing corrected LBBB but injured the right bundle branch, highlighting the need for temporary pacing during the procedure.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Pacing

Background:

  • Dilated cardiomyopathy (DCM) is a complex condition affecting heart muscle function.
  • Left bundle branch block (LBBB) is a recognized arrhythmia that can be associated with cardiac dysfunction.
  • His bundle pacing is an advanced pacing technique aiming for physiological ventricular activation.

Observation:

  • A 61-year-old woman presented with severe nonischemic dilated cardiomyopathy and LBBB.
  • Permanent His bundle pacing was performed to address the LBBB.
  • The procedure resulted in immediate LBBB correction but caused iatrogenic right bundle branch injury.

Findings:

  • The patient experienced subsequent recovery of right bundle branch block.
  • Heart function normalized during the follow-up period.
  • This suggests a potential causal link between LBBB and nonischemic DCM.

Implications:

  • LBBB may contribute to the development or progression of nonischemic dilated cardiomyopathy.
  • Temporary pacing is crucial during His bundle pacing in LBBB patients to mitigate risks.
  • This case underscores the importance of careful procedural management in cardiac pacing.

Keywords:
His bundle pacingLeft bundle branch blockcardiomyopathyheart failureright bundle branch injurytemporary pacemaker

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