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Reversal of pacing-induced cardiomyopathy after left bundle branch area pacing: a case report

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dc.contributor.authorKwon, Soonil-
dc.contributor.authorLee, So-Ryoung-
dc.contributor.authorChoi, Eue-Keun-
dc.contributor.authorOh, Seil-
dc.date.accessioned2024-02-26T07:00:48Z-
dc.date.available2024-02-26T16:01:34Z-
dc.date.issued2023-02-07-
dc.identifier.citationInternational Journal of Arrhythmia,Vol.24 no.5ko_KR
dc.identifier.issn2466-1171-
dc.identifier.urihttps://hdl.handle.net/10371/199020-
dc.description.abstractBackground
Conventional right ventricular apex (RVa) pacing increases the risk of pacing-induced cardiomyopathy (PICM), especially in elderly patients with a higher ventricular pacing burden. Left bundle branch area pacing (LBBAP) has been suggested as an alternative to conventional RVa pacing. However, there is a lack of evidence that LBBAP may reverse PICM. We report a case of a reversal of PICM after LBBAP.

Case presentation
An 81-year-old woman with a history of complete atrioventricular block and baseline QRS duration of 142 ms received permanent pacemaker implantation with dual pacing. The ventricular lead was placed at the apical direction and paced QRS duration was 146 ms. After 8 months, the patient visited with acute heart failure. The patients ventricular pacing burden was > 99%, and echocardiography found severe depression of left ventricular ejection fraction (LVEF, 30%), left ventricular dyssynchrony, and global hypokinesia. Despite 3 months of optimal medical management of heart failure, there was minimal improvement in LVEF (35%) and ventricular dyssynchrony persisted. The patient's presentation was consistent with PICM. LBBAP was performed with a stylet-driven lead and a delivery sheath (Biotronik Selectra 3D, Biotronik, Berlin, Germany). The lead was placed at the area of the left bundle branch trunk and non-selective LBBAP was achieved with a left ventricular activation time of 71 ms, paced QRS duration of 110 ms, and bipolar stimulation to QRS end of 136 ms. After a month, echocardiography found improved LVEF (53%) and N-terminal Pro-B-Type natriuretic peptide was decreased from 1011 to 645 pg/mL. The patient was relieved from dyspnea.

Conclusions
We report a case that PICM was resolved after LBBAP. LBBAP could be a rescue therapy for PICM induced by conventional RVa pacing.
ko_KR
dc.language.isoenko_KR
dc.publisherBMCko_KR
dc.subjectConduction system pacing-
dc.subjectPacing-induced cardiomyopathy-
dc.subjectLeft bundle branch area pacing-
dc.titleReversal of pacing-induced cardiomyopathy after left bundle branch area pacing: a case reportko_KR
dc.typeArticleko_KR
dc.identifier.doi10.1186/s42444-023-00087-1ko_KR
dc.citation.journaltitleInternational Journal of Arrhythmiako_KR
dc.language.rfc3066en-
dc.rights.holderThe Author(s)-
dc.date.updated2023-03-30T09:54:22Z-
dc.citation.endpage6ko_KR
dc.citation.number5ko_KR
dc.citation.startpage1ko_KR
dc.citation.volume24ko_KR
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