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A 201T1 perfusion defect in a case with rate-dependent left bundle-branch block (LBBB)
European Journal of Nuclear Medicine
|January 1, 1985
Summary
A 67-year-old woman experienced rate-dependent left bundle-branch block (LBBB). Myocardial scintigraphy revealed reversible defects during pacing-induced LBBB, despite normal coronary angiography, suggesting non-obstructive causes.
Area of Science:
- Cardiology
- Nuclear Cardiology
- Electrophysiology
Background:
- Rate-dependent left bundle-branch block (LBBB) can present diagnostic challenges.
- Coronary angiography is standard for evaluating obstructive coronary artery disease.
Observation:
- A 67-year-old woman presented with rate-dependent LBBB.
- Right-atrial pacing induced LBBB.
- Coronary angiography showed no significant obstructive lesions.
Findings:
- 201Tl myocardial scintigraphy demonstrated a reversible focal defect during pacing-induced LBBB.
- This suggests myocardial dysfunction not explained by obstructive coronary artery disease.
Implications:
- Pacing-induced LBBB can unmask underlying myocardial perfusion abnormalities.
- This case highlights the utility of provocative testing in diagnosing non-obstructive causes of LBBB.
- Further investigation into non-ischemic cardiomyopathies may be warranted.