Permanent Bi-Bundle Pacing in a Patient With Heart Failure and Left Bundle Branch Block
Brian Vezi1, Olumuyiwa P Akinrimisi2
1Gateway Hospital, Umhlanga, South Africa.
JACC. Case Reports
|January 23, 2023
Summary
Left bundle branch pacing (LBBP) effectively treats heart failure in patients with low ejection fraction. Bi-bundle pacing can further improve outcomes by resolving pacing-induced blockages and narrowing the QRS duration.
Area of Science:
- Cardiology
- Electrophysiology
- Heart Failure Management
Background:
- Left bundle branch pacing (LBBP) is an established treatment for heart failure with reduced ejection fraction (HFrEF).
- LBBP can induce incomplete right bundle branch block (iRBBB), potentially altering ventricular conduction.
- Optimizing pacing strategies is crucial for maximizing benefits in heart failure patients.
Observation:
- The study investigates the effects of bi-bundle pacing in patients undergoing LBBP.
Findings:
- Bi-bundle pacing demonstrates the capability to resolve iRBBB.
- This technique can further decrease QRS duration beyond standard LBBP.
- Potential for improvement in LVEF is suggested.
Implications:
- Bi-bundle pacing offers a novel strategy to mitigate or resolve LBBP-induced conduction abnormalities.
- This approach may enhance the efficacy of cardiac resynchronization therapy in specific heart failure populations.
- Further research into bi-bundle pacing could refine heart failure treatment protocols.
Keywords:
BBP, bi-bundle pacingCRT, cardiac resynchronization therapyECG, electrocardiogramHF, heart failureLBBB, left bundle branch blockLVEF, left ventricular ejection fractionRBBB, right bundle branch blockacute heart failurecardiac resynchronization therapychronic heart failuresecondary preventionsystolic heart failure
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