Key result
LBBaP resolves syncope and maintains stable pacing in atrial standstill with a giant atrium.
Why the study?
Traditional right ventricular apical pacing causes dyssynchrony, and the application of physiological left bundle branch area pacing in exceptional conditions is rarely reported.
Case Report (n=1)
No
LBBaP can be successfully applied as a physiological pacing strategy in patients with atrial standstill and a giant atrium.
LBBaP may be feasible in atrial standstill with giant atrium; leaves open need for prospective validation before wider use.
Atrial standstill (AS) is a rare condition defined by the lack of atrial electrical and mechanical activities. It is usually clinically manifested as symptomatic bradycardia, which requires permanent pacemaker (PPM) implantation. Traditional right ventricular apical pacing causes electrical and mechanical dyssynchrony resulting in left ventricular dysfunction, heart failure, and arrhythmias. As a novel physiological pacing strategy, left bundle branch area pacing (LBBaP) has demonstrated effectiveness and safety in recent years, but its application in exceptional conditions is rarely reported. We report the case of a 47-year-old female, who was diagnosed with AS complicated with a giant atrium, and successfully received a single-chamber PPM with LBBaP.
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Zheng et al. (2022) conducted a case report in Atrial standstill with giant atrium (n=1). Left bundle branch area pacing (LBBaP) was evaluated on Successful LBBaP implantation and clinical symptom resolution. Left bundle branch area pacing was successfully implanted in a patient with atrial standstill and a giant atrium, resulting in stable pacing parameters and freedom from syncope.
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