His bundle pacing in older patient with continuous proximal atrio-ventricular block after myocardial infarction

<ns3:p>His bundle pacing (HBP) synchronizes atrio-ventricular and intraventricular delays. We observed the relationship between the level of atrio-ventricular block, ventricles synchrony, diastolic function improvement in a patient with moderate systolic disorders and diastolic dysfunction after myocardial infarction. HBP may be useful to treat conduction disorders and prevent further systolic and diastolic dysfunction. We present the case of a 92-year-old man in a very good general psychophysical status, treated with percutaneous coronary intervention of circumferential branch of left coronary artery angioplasty due to myocardial infarction, regional contractility disorders of left ventricle with ejection fraction (LVEF) 45%, and observed long PR interval with paroxysmal second degree atrioventricular conduction block. A successful implantation of a permanent HBP lead in the postinfarction period was performed. The His bundle capture restored AV synchrony and diminished diastolic disorders. Our case demonstrates that atrioventricular conduction disorders in the course of myocardial infarction may be corrected by HBP.</ns3:p>