Painful Left Bundle Branch Block Syndrome Treated With Conduction System Pacing. A Report of Two Cases
Catalin Pestrea1, Constantin Guzgan1, Ecaterina Cicala1
1Department of Interventional Cardiology Brasov County Clinical Emergency Hospital Brasov Romania.
Clinical Case Reports
|July 15, 2025
Summary
Painful left bundle branch block (LBBB) syndrome, characterized by chest pain without ischemia, can be effectively treated. Conduction system pacing (CSP) successfully corrected LBBB, resolving chest pain and improving heart function in two patients.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Painful left bundle branch block (LBBB) syndrome presents as chest pain linked to LBBB without myocardial ischemia.
- Ventricular dyssynchrony induced by LBBB is the suspected cause of chest pain.
Purpose of the Study:
- To report on two cases of painful LBBB syndrome in patients with non-ischemic cardiomyopathy.
- To demonstrate the efficacy of conduction system pacing (CSP) in managing this rare condition.
Main Methods:
- Two patients with non-ischemic cardiomyopathy, chest pain, and intermittent LBBB underwent CSP.
- Diagnosis was confirmed by correlating chest pain onset/remission with LBBB occurrence/correction.
Main Results:
- Successful CSP (His bundle and left bundle branch area pacing) completely corrected LBBB.
- Chest pain resolved, and left ventricular function improved in both patients at six-month follow-up.
Conclusions:
- Conduction system pacing is a viable and effective treatment for painful LBBB syndrome.
- CSP can alleviate chest pain and improve cardiac function in affected individuals.
Keywords:
His‐bundle pacingleft bundle branch area pacingmyocardial ischemiapainful left bundle branch blockventricular dyssynchronyMore Related Videos
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