Conduction System Pacing in Pediatrics and Congenital Heart Disease: A Case Report and Literature Review

Area of Science:

• Cardiology
• Electrophysiology
• Pediatric Heart Disease

Background:

• Conduction system pacing, including His bundle pacing (HBP) and left bundle branch pacing (LBBP), is an alternative to right ventricular (RV) pacing.
• This pacing modality aims to prevent pacemaker-associated cardiomyopathy.
• LBBP has demonstrated safety and efficacy in pediatric populations in prior small studies.

Purpose of the Study:

• To present a case of successful left bundle branch pacing (LBBP) in a pediatric patient with congenital heart disease.
• To evaluate the transition from RV pacing to LBBP for improving left ventricular function.
• To provide a foundation for reviewing LBBP in pediatrics and congenital heart disease.

Main Methods:

• Case report detailing a patient with congenital atrioventricular block and cardiomyopathy post-ventricular septal defect repair.
• Transition of pacing from a right ventricular (RV) epicardial system to a left bundle branch pacing (LBBP) system.
• Assessment of left ventricular function post-pacing system change.

Main Results:

• The patient experienced improvement in left ventricular function after transitioning to LBBP.
• This suggests LBBP can be effective in pediatric patients with specific cardiac conditions.
• The case supports LBBP as a viable alternative to RV pacing in complex pediatric cases.

Conclusions:

• Left bundle branch pacing (LBBP) is a safe and effective alternative to right ventricular (RV) pacing in pediatric patients.
• LBBP can lead to significant improvement in left ventricular function in patients with congenital heart disease and cardiomyopathy.
• Further research and case reviews are warranted to establish LBBP's role in pediatric and congenital heart disease management.