Left bundle branch pacing was successfully implanted in a 2-year-old child with congenital complete heart block and recurrent torsades de pointes, resulting in clinical and echocardiographic improvement.
A 2-year-old girl was referred to the Harapan Kita National Heart Center due to the return of spontaneous circulation after cardiac arrest, bradyarrhythmia and repeated seizures with loss of consciousness. She had been treated with an epilepsy drug for 1 year. Electrocardiography during one epilepsy episode showed complete heart block with junctional escape rhythm and QT interval prolongation, which then progressed to torsades de pointes. Echocardiography revealed left atrium and left ventricle dilatation with reduced ejection fraction. Left bundle branch permanent pacemaker was successfully implanted through left subclavian vein access. During the 3-week follow-up, there were no recurrent seizures and echocardiography revealed improvement of left ventricle ejection fraction.
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Hidayati et al. (2023) studied this question.
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