Painful Left Bundle Branch Block Syndrome Successfully Treated With Left Bundle Branch Area Pacing
Aatish Garg1, Vivak Master1, Kenneth A Ellenbogen1
1Division of Cardiac Electrophysiology, Virginia Commonwealth University Medical Center, Richmond, Virginia.
JACC. Case Reports
|July 28, 2021
Summary
Left bundle branch block (LBBB) can cause chest pain due to dyssynchrony. Pacing in the left bundle branch area successfully resolved LBBB and symptoms in two patients.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Pacing
Background:
- Left bundle branch block (LBBB) is infrequently linked to ventricular dyssynchrony and chest pain.
- Understanding the mechanisms of LBBB-induced symptoms is crucial for effective management.
Observation:
- Two cases presented with chest pain attributed to LBBB-mediated ventricular dyssynchrony.
- Conventional pacing strategies may not always address the underlying dyssynchrony effectively.
Findings:
- Left bundle branch area pacing (LBBAP) was successfully implemented in both patients.
- LBBAP resulted in the resolution of LBBB and alleviation of associated chest pain.
- Optimizing atrioventricular delays during LBBAP further narrowed QRS duration through fusion pacing.
Implications:
- LBBAP offers a promising therapeutic option for select patients with LBBB and related symptoms.
- This approach may improve cardiac resynchronization and patient outcomes.
- Further research into LBBAP optimization is warranted.
Keywords:
AV, atrioventricularHBP, His bundle pacingLBBAP, left bundle branch area pacingLBBB, left bundle branch blockcardiac pacemakercardiac resynchronization therapychest painMore Related Videos
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