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Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
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Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Related Experiment Video

Updated: Sep 4, 2025

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Reversible T-wave inversions during left bundle branch area pacing.

Jie Geng1, Zhixin Jiang1, Shigeng Zhang1

  • 1Department of Cardiology, 1st Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Kardiologia Polska
|July 15, 2022
PubMed
Summary

T-wave inversions (TWIs) are common after left bundle branch area pacing (LBBAP) and often resolve. A QRS duration over 120 ms independently predicts TWIs during LBBAP.

Keywords:
T-wave inversionscardiac memorycomplete left bundle branch blockcomplete right bundle branch blockleft bundle branch area pacing

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Pacing

Background:

  • T-wave inversions (TWIs) are observed during left bundle branch area pacing (LBBAP).
  • The incidence and influencing factors of TWIs during LBBAP were not well understood.

Purpose of the Study:

  • To investigate the effects of LBBAP on T-waves.
  • To identify factors associated with TWIs following LBBAP.

Main Methods:

  • Retrospective cohort study of 398 patients undergoing LBBAP.
  • Electrocardiograms (ECGs) analyzed at baseline and post-pacing.
  • Multivariable logistic regression used to identify predictors of TWIs.

Main Results:

  • TWIs occurred in 66.3% of patients post-LBBAP.
  • Baseline QRS duration >120 ms was an independent predictor of TWIs (P <0.001).
  • TWIs showed significant recovery in 87.8% of patients during follow-up.

Conclusions:

  • TWIs are frequent and typically recoverable after LBBAP.
  • Prolonged QRS duration (>120 ms) is independently associated with TWIs during LBBAP.