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Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
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Exercise-Induced Left Bundle Branch Block in a Patient With Syncope: A Case Report.

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Exercise-induced left bundle branch block (EI-LBBB) can occur even without structural heart disease. This case report highlights a patient who improved symptomatically with an aerobic exercise program, suggesting a potential management strategy.

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Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Exercise-induced left bundle branch block (EI-LBBB) is uncommon, especially in individuals without structural heart disease.
  • The underlying pathophysiology of EI-LBBB is not well understood, and established treatment guidelines are lacking.

Purpose of the Study:

  • To present a case of EI-LBBB in a patient with minimal coronary artery disease.
  • To discuss the evaluation and management of EI-LBBB, including the role of exercise training.

Main Methods:

  • Case report of a 77-year-old male experiencing syncope and EI-LBBB during a cardiac stress test.
  • Diagnostic workup included coronary angiography and comprehensive cardiac evaluation.
  • Management involved initiating an aerobic exercise program.

Main Results:

  • The patient exhibited transient electrocardiographic changes consistent with EI-LBBB during stress testing, which resolved at rest.
  • Coronary angiography showed only mild-moderate stenosis in the proximal left anterior descending artery.
  • The patient reported symptomatic improvement following the commencement of an aerobic exercise program.

Conclusions:

  • EI-LBBB can manifest in patients with normal cardiac structure and minimal coronary artery disease.
  • Aerobic exercise training may be a viable management option for selected EI-LBBB patients.
  • Further research is needed to elucidate EI-LBBB pathophysiology and establish treatment protocols.