Left bundle branch pacing in third-degree atrioventricular block following morrow surgery: a case report
Keqiang Huang1, Hongmei Gan1, Jingjing Jiang1
1Department of Cardiology, Wuhan Asia General Hospital, Wuhan, Hubei, China.
Frontiers in Cardiovascular Medicine
|August 12, 2024
Summary
Left bundle branch pacing (LBBP) offers physiological pacing for left ventricular (LV) electrical synchrony. This case study demonstrates successful LBBP in a patient with third-degree atrioventricular block after Morrow surgery, despite potential left bundle branch damage.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Surgery
Background:
- Left bundle branch pacing (LBBP) is an effective method for achieving left ventricular (LV) electrical synchrony, particularly in patients with atrioventricular block and left bundle branch block (LBBB).
- The Morrow operation (septal myectomy) for hypertrophic obstructive cardiomyopathy (HOCM) can cause iatrogenic damage to the left bundle branch (LBB), potentially complicating pacing strategies.
- Pacemaker implantation is required in 2%-12% of patients post-Morrow surgery, highlighting the need for effective pacing solutions.
Observation:
- This case report focuses on a patient with third-degree atrioventricular block (AVB) following Morrow surgery.
- The patient's left bundle branch (LBB) sustained surgery-induced damage.
Findings:
- Successful Left Bundle Branch Pacing (LBBP) was achieved in a patient with third-degree atrioventricular block (AVB) after Morrow septal myectomy.
- LBBP provided effective electrical resynchronization despite LBB damage.
Implications:
- LBBP is a viable and effective pacing strategy for AVB patients with surgically compromised LBBs.
- This case expands the understanding of LBBP applicability in complex cardiac conditions.
- Further research is warranted to confirm LBBP efficacy in similar post-surgical cases.
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