Key result
Stent placement in the proximal LAD in a 66-year-old man with baseline left bundle branch block resulted in persistent complete atrioventricular block due to septal branch occlusion.
Case Report (n=1)
Highlights the critical need to maintain blood flow to septal perforators during LAD interventions in patients with pre-existing LBBB to prevent complete heart block.
May prompt septal perforator protection during proximal LAD stenting in baseline LBBB; hypothesis-generating for preventive strategies.
A 66-year-old man with a baseline electrocardiogram (ECG) showing left bundle branch block developed persistent complete atrioventricular block following stent placement in the proximal left anterior descending artery (LAD), necessitating permanent pacemaker implantation. The complication is believed to have resulted from occlusion of the second septal branch, which likely supplied the right bundle of the His system. During elective interventions targeting the LAD in patients with pre-existing conduction abnormalities, it is crucial to maintain adequate blood flow to the septal perforators.
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Manasrah et al. (2025) conducted a case report in Left bundle branch block (n=1). Stent placement in the proximal left anterior descending artery was evaluated on Complete atrioventricular block. Stent placement in the proximal LAD in a 66-year-old man with baseline left bundle branch block resulted in persistent complete atrioventricular block due to septal branch occlusion.
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