Key result
A dual chamber pacemaker with left bundle branch area pacing in a 75-year-old woman post-TAVR resulted in functional atrial undersensing causing loss of ventricular electric resynchronization.
Case Report (n=1)
This case highlights the importance of recognizing functional atrial undersensing in left bundle branch area pacing and suggests a stepwise approach using device reprogramming and pharmacological intervention to resolve it.
Potential atrial undersensing may disrupt LBBAP resynchronization post-TAVR; leaves open optimal dual-chamber programming strategies.
We present the case of a 75-year-old woman with severe aortic stenosis and moderate left ventricular dysfunction, who underwent elective transcatheter aortic valve replacement. After the procedure, the patient developed a left bundle branch block and a long PR interval. For this reason, a dual chamber pacemaker with pacing in the left bundle branch area was implanted. On device interrogation, we confirmed the presence of functional atrial undersensing causing loss of ventricular electric resynchronization. This case highlights the importance of recognizing this problem and, by means of device reprogramming and pharmacological intervention, suggests a stepwise approach to solve it.
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Castro et al. (2022) conducted a case report in Severe aortic stenosis and moderate left ventricular dysfunction (n=1). Dual chamber pacemaker with pacing in the left bundle branch area was evaluated on Functional atrial undersensing causing loss of ventricular electric resynchronization. A dual chamber pacemaker with left bundle branch area pacing in a 75-year-old woman post-TAVR resulted in functional atrial undersensing causing loss of ventricular electric resynchronization.
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