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Updated: Oct 4, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Left bundle branch pacing in hypertrophic cardiomyopathy-a novel approach

Soumya Patra1, Ashesh Halder1, Rabin Chakraborty1

  • 1Department of Cardiology, Medica Superspecialty Hospital Kolkata, West Bengal, India.

American Journal of Cardiovascular Disease
|February 4, 2022
PubMed

Insights

This study presents a novel approach for treating sick sinus syndrome in hypertrophic cardiomyopathy (HCM) using left bundle branch (LBB) pacing. This new technique offers stable pacing parameters in non-obstructive HCM patients.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiovascular Medicine

Background:

  • Symptomatic bradycardia due to sick sinus syndrome is uncommon in hypertrophic cardiomyopathy (HCM).
  • Conventional treatment involves dual chamber pacing with right ventricular apical lead placement.
  • Physiological pacing, including left bundle branch (LBB) pacing, is an emerging alternative.

Observation:

  • Left bundle branch (LBB) pacing is technically challenging in HCM due to septal hypertrophy.
  • No previous reports exist on LBB pacing in adult HCM patients with sick sinus syndrome.
  • This study details a novel approach for symptomatic sinus node dysfunction in non-obstructive HCM.

Findings:

  • Left bundle branch (LBB) pacing was successfully implemented in a patient with non-obstructive HCM and sick sinus syndrome.
  • Pacing parameters remained stable at 3 months post-implantation.
  • This represents a novel application of LBB pacing in this specific patient population.

Implications:

  • Left bundle branch (LBB) pacing may be a viable and effective physiological pacing strategy for select HCM patients with sick sinus syndrome.
  • This approach could offer an alternative to conventional pacing in non-obstructive HCM.
  • Further research is warranted to explore the long-term efficacy and safety of LBB pacing in HCM.

Keywords:
Sick sinus syndromedual chamber pacinghypertrophic cardiomyopathyleft bundle pacing

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