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Updated: Aug 28, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Pseudo-pacemaker syndrome triggered by atrioventricular hysteresis algorithm activation in a patient with left bundle
Luca Nolte1, Corinna Lenz1, Max Olav Schrage1
1Department of Internal Medicine and Cardiology, BG Klinikum Unfallkrankenhaus Berlin, Warener Str. 7, 12683, Berlin, Germany.
Abstract:
Atrioventricular (AV) hysteresis algorithms are designed to minimize unnecessary ventricular pacing. This case report describes a young patient with left bundle branch area pacing (LBBAP) in whom activation of an AV-hysteresis algorithm resulted in excessive prolongation of AV intervals, leading to ineffective AV synchrony and recurrence of symptoms consistent with a pseudo-pacemaker syndrome despite permanent pacemaker implantation, including dizziness and near-syncope. The case highlights the importance of careful device programming, particularly in patients undergoing conduction system pacing.
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