Key result
Acute anterior MI causes transient loss of LBBP capture that resolves after PCI.
Case Report (n=1)
No
Acute anterior wall myocardial infarction can cause transient loss of ventricular capture in patients with left bundle branch pacing, which may recover as ischemia improves.
May warrant threshold monitoring during anterior MI in LBBP; leaves open generalizability beyond this case.
Compared with traditional right ventricular apical pacing, His-bundle pacing (HBP) provides more physiologic pacing by activating the normal conduction system. However, HBP has some limitations including higher pacing thresholds. In addition, disease in the distal His-Purkinje system may prevent the correction of abnormal conduction. Left bundle branch pacing (LBBP) may overcome these disadvantages by providing lower pacing thresholds and relatively narrow QRS duration that improve cardiac function. Here, we describe a rare case of a transient loss of ventricular capture due to acute anterior wall myocardial infarction in an LBB-paced patient. With the improvement of the ischemia, the function of the pacemaker partly recovered. We review the adaptations, advantages, and limitations, and long-term safety of LBBP.
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Zhang et al. (2022) conducted a case report in Acute myocardial infarction with left bundle branch pacing (n=1). Left bundle branch pacing (LBBP) and percutaneous coronary intervention (PCI) was evaluated on Pacing threshold. In a patient with left bundle branch pacing, acute anterior wall myocardial infarction caused a transient loss of ventricular capture and increased pacing threshold to 5.0 V/0.4 ms, which recovered to 1.75 V/0.4 ms after percutaneous coronary intervention.
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