Impact of Pulmonary Vein Isolation on Left Bundle Branch Block Following Tachycardia-induced Cardiomyopathy in a Patient with Persistent Atrial Fibrillation

Abstract

A 61-year-old man was referred to our hospital with exertional dyspnea. Electrocardiography showed atrial fibrillation (AF) with a heart rate of 116 bpm and left bundle branch block (LBBB). Chest radiography demonstrated pulmonary congestion and cardiomegaly with a cardiothoracic ratio of 57%. Transthoracic echocardiography revealed a severely reduced left ventricular systolic function (ejection fraction: 32%), suggesting tachycardia-induced cardiomyopathy (TIC) due to AF. Following treatment for congestive heart failure and complete isolation of each pulmonary vein, the LBBB disappeared, with a complete recovery of the cardiac systolic function. This report describes a case of transient reversible LBBB associated with systolic dysfunction treated with catheter ablation.

Episodic Left Bundle Branch Block—A Comprehensive Review of the Literature

“…Episodic LBBB has been reported in several diverse clinical conditions. These are the following: coronary fistulas connecting main pulmonary artery with coronary arteries, chest trauma, cervical wound, Guillain‐Barre syndrome, takotsubo cardiomyopathy, Graves‐Basedow disease, hemorrhagic stroke, myocarditis in enteric fever, myocarditis along with acute ischemic cerebellar, pontine and lacunar infarction following viper bite, electroconvulsive therapy, endoscopic retrograde cholangiopancreatography, athletic heart syndrome, tachycardia induced cardiomyopathy, endoscopic brachytherapy for lung cancer, and propionic aciduria…”

Bloqueo de rama intermitente revision de tema y abordaje de una entidad clinica compleja

“…Estas son las siguientes: fístulas coronarias que conectan la arteria pulmonar principal con las arterias coronarias (Ito et al, 1998), (Juraschek et al, 2011), trauma torácico (Pizzo et al, 2005), (Ishikawa et al, 2014), síndrome de Guillain-Barr (Serrano Júnior et al, 1987), miocardiopatía de takotsubo (Di Cori et al, 2010), enfermedad de Graves-Basedow (Lubczynska-Kowalska et al, 1971), accidente cerebrovascular hemorrágico (Martynov et al, 2004), miocarditis en fiebre entérica (Prabha et al, 1995), miocarditis junto con infarto isquémico agudo cerebeloso, pontino y lacunar después de la mordedura de una víbora (Bhatt et al, 2013), terapia electroconvulsiva (D. A. Adams et al, 2014) colangiopancreatografía retrógrada endoscópica (Kounis et al, 2003), síndrome del corazón atlético (Chapman, 1977), miocardiopatía inducida por taquicardia (Senoo et al, 2014) y braquiterapia endoscópica para el cáncer de pulmón (Vasic et al, 2011).…”

What is the role of left bundle branch block in atrial fibrillation-induced cardiomyopathy?

“…Previous studies [4,5] reported cases of reversible CLBBB following AF-induced cardiomyopathy after control of heart failure with drugs or rhythm control with pulmonary vein isolation. And mechanical damage to the left bundle branch was suggested to be the most possible cause of LBBB associated with tachycardia induced cardiomyopathy [4,5]. However, it is not the same in our case.…”