Does left bundle branch area pacing improve symptoms in patients with painful left bundle branch block syndrome?
Left bundle branch area pacing is proposed as a potential treatment option for painful left bundle branch block syndrome to reestablish normal ventricular activation.
Painful left bundle branch block (LBBB) syndrome causes intermittent or chronic chest pain and/or shortness of breath in the absence of myocardial ischemia.1 Given its low prevalence and association with coronary artery disease, it is frequently not recognized, making its true prevalence unknown. The mechanistic nature of the associated chest pain has not been completely elucidated but is thought to be related to ventricular dyssynchrony2 and interoceptive hypersensitivity.3 Treatment options include the use of beta-blockers to reduce heart rate and cardiac pacing therapy aimed at reestablishing normal ventricular activation, through biventricular or His bundle pacing (HBP).
Cerantola et al. (Fri,) studied this question.