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Updated: Mar 3, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

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Rate-Dependent Left Bundle Branch Block: An Electro-mechanical Study.

Thomas Van Overmeiren¹, Emine Özpak¹, Simon Calle¹

¹Department of Cardiology, Ghent University Hospital, Ghent, Belgium.

Pacing and Clinical Electrophysiology : PACE

|March 2, 2026

Summary

This summary is machine-generated.

Rate-dependent left bundle branch block (rdLBBB) is a rare condition seen during exercise testing. It often progresses to permanent left bundle branch block (LBBB) and is linked to mechanical dyssynchrony and reduced heart function.

Keywords:

cardiac resynchronization therapy dyssynchrony electrophysiology left bundle branch block rate‐dependent left bundle branch block

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Area of Science:

Cardiology
Electrophysiology
Diagnostic Imaging

Background:

Rate-dependent left bundle branch block (rdLBBB) is a rare finding during exercise testing, affecting 0.5%-1% of patients.
It presents as an acute and transient form of left bundle branch block (LBBB).

Purpose of the Study:

To investigate the electromechanical characteristics of rdLBBB during exercise.
To determine the natural history and progression of rdLBBB.

Main Methods:

Retrospective analysis of 50 patients diagnosed with rdLBBB.
Prospective inclusion for supine bicycle echocardiography to assess electromechanical dyssynchrony.

Main Results:

rdLBBB met LBBB criteria in 95% of cases.
60% of patients progressed to permanent LBBB within 3 years; lower onset heart rate and left ventricular ejection fraction (LVEF) were predictors.
Acute mechanical dyssynchrony, including septal flash, was observed, particularly in patients with lower baseline LVEF.

Conclusions:

rdLBBB is a distinct entity characterized by sudden onset and typical LBBB features.
The severity of dyssynchrony appears related to baseline LVEF.
Exercise-induced left ventricular dysfunction may occur in patients with rdLBBB.