Key result
Conservative management resolves LBBAP-induced interventricular septal hematoma and ventricular arrhythmias within one month.
Why the study?
This report outlines the presentation of an emerging complication arising from left bundle branch area pacing.
Case Report (n=1)
No
Interventricular septal hematoma is a rare complication of left bundle branch area pacing that can present with ventricular arrhythmias and may be successfully managed conservatively.
May prompt post-LBBAP arrhythmia vigilance; single case leaves open incidence, prevention, and generalizability.
BACKGROUND: This case report outlines the presentation of an emerging complication arising from left bundle branch area pacing (LBBAP). CASE SUMMARY: A 43-year-old male with no history of cardiac problems experienced recurrent episodes of syncope with no prodromal symptoms. During monitoring in the emergency department, the patient underwent an episode of asystole, leading to LBBAP implantation. The procedure encountered technical challenges, resulting in an interventricular septal hematoma and subsequent ventricular arrhythmias. Despite initial concerns, conservative management led to resolution, demonstrated through echocardiographic follow-ups. DISCUSSION: This report underscores the significance of ventricular arrhythmias as indicators of interventricular septal hematoma, providing insights into its diagnosis, management, and implications for LBBAP procedures.
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Pastori et al. (2024) conducted a case report in Recurrent syncope and asystole requiring pacing (n=1). Left bundle branch area pacing (LBBAP) was evaluated on Resolution of interventricular septal hematoma. An interventricular septal hematoma complicating left bundle branch area pacing presented with ventricular arrhythmias and completely resolved within one month using conservative management.
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