September 17, 2026Pacing and Clinical Electrophysiology
Left Ventricular Pacing‐Associated Cardiomyopathy Revealing Myocardial Vulnerability in Congenital Complete Heart Block
Key result
LV pacing linked to DCM in congenital heart block, with subsequent improvement after CRT.
- n=1
Why the study?
Mechanisms underlying cardiac manifestations of immune-mediated congenital complete heart block remain unclear, with limited data on left ventricular pacing-associated dilated cardiomyopathy.
Population
A girl with immune-mediated congenital complete heart block and endocardial fibroelastosis
Comparison
Left ventricular basal-lateral pacing followed by cardiac resynchronization therapy
Design
Case report
Authors
Discussion
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Implication
LV pacing may induce DCM in immune-mediated CCHB; extends RV pacing associations and is hypothesis-generating for CRT reversal.
Key Points
- Investigate the mechanisms linking left ventricular pacing, myocardial vulnerability, and dilated cardiomyopathy in immune-mediated congenital complete heart block.
- Documented a clinical case of an infant diagnosed with fetal endocardial fibroelastosis at 20 weeks of gestation and immune-mediated congenital complete heart block at 22 weeks.
- Monitored cardiac outcomes following surgical left ventricular basal-lateral pacing and subsequent conversion to cardiac resynchronization therapy.
- Left ventricular basal-lateral pacing led to mechanical left ventricular dyssynchrony and triggered dilated cardiomyopathy.
- Conversion to cardiac resynchronization therapy improved left ventricular function and achieved successful cardiac reverse remodeling.
Study Design
Type
Case Report (n=1)
Structured PICO
P
Population
1 female infant with immune-mediated congenital complete heart block who developed dilated cardiomyopathy after left ventricular pacing.
E
Exposure
Left ventricular (LV) basal-lateral pacing, followed by cardiac resynchronization therapy (CRT)
O
Outcome
Development of dilated cardiomyopathy (DCM) with LV dyssynchrony, and subsequent improvement in LV function and reverse remodelingsurrogate
This case highlights that myocardial injury may precede conduction system involvement in immune-mediated CCHB, and that CRT can effectively reverse LV pacing-associated dilated cardiomyopathy.
Cite This Study
Kaneko et al. (2026) conducted a case report in Immune-mediated congenital complete heart block (CCHB) (n=1). Left ventricular pacing and cardiac resynchronization therapy was evaluated. In a girl with immune-mediated congenital complete heart block, left ventricular pacing was associated with dilated cardiomyopathy, which subsequently improved with cardiac resynchronization therapy.