Key result
LBBAP restores physiologic pacing and resolves symptoms in advanced, alternating AV block.
Why the study?
Idiopathic third-degree AV block in a young patient is uncommon, and alternating first-, second-, and third-degree AV blocks are exceedingly rare.
Case Report (n=1)
No
LBBAP successfully achieved physiologic pacing and symptom resolution in a young patient presenting with an unusual alternating pattern of high-grade AV blocks.
LBBAP may resolve symptoms in young adults with idiopathic alternating AV block; hypothesis-generating and should not yet change practice.
Idiopathic third-degree atrioventricular (AV) block in a relatively young patient is an uncommon phenomenon. Even more rare is when the third-degree heart block is alternating with the first- and second-degree AV blocks. In this case, we present a 39-year-old man with varying degrees of AV block, alternating the third-degree, second-degree, and first-degree AV blocks. The patient underwent an extensive workup for underlying etiologies, and results were inconclusive. A pacemaker was implanted and set for physiologic pacing via left bundle branch area pacing (LBBAP). This case will discuss potential genetic abnormalities associated with AV block and highlight LBBAP as an emerging technique for physiologic pacing.
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Huerta et al. (2023) conducted a case report in Alternating first-, second-, and third-degree atrioventricular block (n=1). Left bundle branch area pacing (LBBAP) was evaluated on Resolution of symptoms and restoration of physiologic pacing. Left bundle branch area pacing (LBBAP) successfully resolved symptoms and achieved physiologic pacing in a 39-year-old man with alternating first-, second-, and third-degree atrioventricular block.
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