What is the clinical evidence from this study?

Study design: Case Report. Population: A 55-year-old middle-aged female patient with left bundle branch block-induced dilated cardiomyopathy (LIC), NYHA class II heart failure, LVEF 26%, QRS duration 168 ms, no ischemic heart disease or hypertension (n=1). Intervention: Cardiac resynchronization therapy (CRT) vs. Pre-treatment status with optimal medical therapy. Primary outcome: Improvement in cardiac function measured by left ventricular ejection fraction (LVEF) and NYHA functional class after CRT.

What question did this study set out to answer?

This research aims to explore the relationship between left bundle branch block and dilated cardiomyopathy, focusing on recovery after treatment.

February 23, 2026BMC Cardiovascular Disorders0 citationsOpen Access

A chicken and egg situation: a case of left bundle branch block-induced dilated cardiomyopathy

BZBo ZhangTianjin Chengjian University FCFuyan ChenGuangxi Medical University HHHua-Zhen HuangThe People's Hospital of Guangxi Zhuang Autonomous Region

Key Result

Cardiac resynchronization therapy increased LVEF from 26% to 53% and improved NYHA class from II to I in a 55-year-old female with LBBB-induced dilated cardiomyopathy at 6 months post-treatment.

Key Points

This research aims to explore the relationship between left bundle branch block and dilated cardiomyopathy, focusing on recovery after treatment.
Described a case study of a middle-aged female patient with complete LBBB and cardiac dysfunction.
Administered cardiac resynchronization therapy and conducted follow-up assessments at 3 and 6 months.
Utilized echocardiography and cardiac magnetic resonance imaging to monitor improvements in cardiac structure and function.
Follow-up assessments showed significant recovery in cardiac function and structure.
NYHA classification improved after surgery, indicating better functional capacity.
Echocardiographic data illustrated enhancements in cardiac functional indicators post-surgery.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

1 55-year-old female patient with complete left bundle branch block (LBBB) and cardiac dysfunction (LVEF 26%, NYHA class II), ultimately diagnosed with LBBB-induced dilated cardiomyopathy (LIC).

Intervention

Cardiac resynchronization therapy (CRT) via implantation of a biventricular resynchronization pacemaker in conjunction with an ICD.

Outcome

Improvement in cardiac structure and function (LVEF, LVDD, LVESD) and NYHA functional class.surrogate

Cardiac resynchronization therapy can lead to significant structural and functional cardiac recovery in patients with LBBB-induced dilated cardiomyopathy, highlighting the importance of early detection using CMR and echocardiography.

Main Result

Absolute Event Rate: 53% vs 26%

Limitations

Single patient case report, thus limited generalizability
Lack of randomized controlled trial data
No control group for direct comparison
Possible reporting bias due to case report format

Abstract

Left bundle branch block (LBBB) mainly occurs in those with heart disease, but also appears in asymptomatic patients with normal heart structure. Determining the causal relationship between LBBB and cardiomyopathy is a current clinical challenge. This article describes a case of a middle-aged female patient with complete LBBB and cardiac dysfunction whose symptoms significantly improved after cardiac resynchronization therapy (CRT). During follow-up assessments at 3 and 6 months postsurgery, echocardiography revealed good recovery of cardiac structure and function, with a significant improvement in cardiac functional classification (NYHA). A comparison of the preoperative and postoperative echocardiographic data revealed that the patient's cardiac structural and functional indicators improved. The patient was ultimately diagnosed with LBBB-induced dilated cardiomyopathy (LIC). Additionally, the potential value of cardiac magnetic resonance (CMR) imaging for predicting the therapeutic effect of CRT on LIC was demonstrated. Through the analysis of medical history, cardiac ultrasound, and CMR imaging, LIC can be detected early and accurately.

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Cite This Study

Zhang et al. (Fri,) conducted a case report in A 55-year-old middle-aged female patient with left bundle branch block-induced dilated cardiomyopathy (LIC), NYHA class II heart failure, LVEF 26%, QRS duration 168 ms, no ischemic heart disease or hypertension (n=1). Cardiac resynchronization therapy (CRT) vs. Pre-treatment status with optimal medical therapy was evaluated on Improvement in cardiac function measured by left ventricular ejection fraction (LVEF) and NYHA functional class after CRT. Cardiac resynchronization therapy increased LVEF from 26% to 53% and improved NYHA class from II to I in a 55-year-old female with LBBB-induced dilated cardiomyopathy at 6 months post-treatment.

synapsesocial.com/papers/699bee551c6c6bad5397ff60 https://doi.org/https://doi.org/10.1186/s12872-026-05626-x

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