The left bundle-branch block (LBBB) is related to worsening cardiac performance. We describe a case of a patient with an intermittent left bundle-branch block who underwent biventricular pacemaker implantation. We noted a detrimental effect on the performance of her left ventricle with the presence of the LBBB as compared to the performance after she underwent biventricular pacing or after reversal of LBBB (i.e., native rhythm with narrow QRS). Her LBBB was accompanied by increased isovolumetric contraction time, longer pre-ejection period, and increased myocardial performance index (i.e., the Tei index) compared to her sinus rhythm with a narrow QRS complex with or under biventricular pacing.
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http://dx.doi.org/10.7759/cureus.2090 | DOI Listing |
Heart Rhythm
December 2024
Electrophysiology Unit. Cardiovascular Division. Hospital del Mar. Passeig Maritim de la Barceloneta. Barcelona. Spain; Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.
Background: Left bundle branch area pacing (LBBAP) needs confirmation of left conduction system capture assessed by testing of different electrical parameters. Guidelines recommend the use of an electrophysiological recording-system (EP-RS) to guide conduction system pacing (CSP) procedures. However, some experienced centers perform LBBAP procedures without an EP-RS.
View Article and Find Full Text PDFCureus
November 2024
Department of Cardiology, Liv Hospital Ulus, Istanbul, TUR.
ESC Heart Fail
December 2024
Boston Scientific Corporation, St. Paul, Minnesota, USA.
Pacing Clin Electrophysiol
December 2024
Servei de Cardiologia, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
Introduction: Right ventricular (RV) pacing can impair left ventricular function and cause heart failure, known as pacing-induced cardiomyopathy (PICM). Upgrade to cardiac resynchronization (CRT) is its usual treatment; recently left bundle branch area pacing (LBBAP) has emerged as a potential alternative. Deep septal pacing (DSP), a simplified alternative to LBBAP, is still able to achieve narrower paced QRS than during conventional RV pacing.
View Article and Find Full Text PDFPacing Clin Electrophysiol
December 2024
Heart Rhythm Centre, Royal Brompton and Harefield Hospitals, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
The use of conduction system pacing (CSP) in adults with congenital heart disease (CHD) is growing, however data remain limited. In patients with congenitally corrected transposition of the great arteries following the double switch operation, existing CSP tools and techniques require modification to allow for the anterior displacement of the atrioventricular node and proximal conduction system in addition to navigating the tortuous route of the atrial redirection. We report the successful use of CSP focusing on the technique of delivery tool modification to allow stability on the basal septum for deployment to the area of the distal His bundle and proximal left bundle branch.
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