Key result
Permanent bi-bundle pacing resolved iatrogenic right bundle branch block and narrowed QRS duration from 150 ms to 90 ms, improving left ventricular ejection fraction from 30% to 38% at 4 weeks.
Why the study?
LBBP leads to iatrogenic incomplete right bundle branch block (iRBBB), which bi-bundle pacing can resolve to further narrow QRS duration and potentially improve LVEF.
Does permanent bi-bundle pacing improve QRS duration and LVEF in a patient with heart failure and left bundle branch block?
Case Report (n=1)
No
Does permanent bi-bundle pacing improve QRS duration and LVEF in a patient with heart failure and left bundle branch block?
Permanent bi-bundle pacing can resolve iatrogenic right bundle branch block caused by left bundle branch pacing, further narrowing QRS duration and improving LVEF in heart failure patients.
Hypothesis-generating for bi-bundle pacing after LBB pacing-induced RBBB; prospective trials needed before clinical adoption.
Left bundle branch pacing (LBBP) is effective in patients with heart failure, left ventricular ejection fraction (LVEF) of ≤35%, and a widened QRS complex. LBBP leads to iatrogenic incomplete right bundle branch block (iRBBB). Bi-bundle pacing can resolve iRBBB, further narrowing the QRS duration, and may improve LVEF. (Level of Difficulty: Advanced.)
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Vezi et al. (2022) conducted a case report in Heart failure and left bundle branch block (n=1). Permanent Bi-Bundle Pacing vs. Baseline was evaluated on QRS duration (ms). Permanent bi-bundle pacing resolved iatrogenic right bundle branch block and narrowed QRS duration from 150 ms to 90 ms, improving left ventricular ejection fraction from 30% to 38% at 4 weeks.
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