Treatment of painful left bundle branch block syndrome with cardiac resynchronization therapy or right-ventricular pacing

Improved symptoms, exercise capacity, and homogeneity of cardiac deformation through conduction system pacing in a patient with symptomatic left bundle branch block

“… 1 , 8 In our patient, physical training had no effect and beta-blocker therapy was not tolerated; therefore we jointly decided for a pacemaker implantation. Even though right ventricular and biventricular pacing have both been reported to be successful in alleviating symptoms in patients with painful LBBB, 9 chronic right ventricular pacing is known to be a risk factor for pacing-induced cardiomyopathy, 10 while CRT implantation carries an increased risk of short- and long-term complications. His bundle pacing presents a valid alternative to restore cardiac electrical synchronicity through physiological stimulation.…”

Painful LBBB syndrome: a rare cause of angina

“…Submaximal aerobic exercise training has been reported to benefit this condition by increasing the heart rate of LBBB onset or offset and, accordingly, resolution of chest pain 1 6. Pacing, including right ventricular pacing, biventricular pacing, and recently, His bundle and left bundle branch pacing, have all been utilised successfully as alternate treatments for drug-refractory painful LBBB syndrome 7–9. The prognosis is generally good, with no adverse events reported on long-term follow-up 10…”

Painful Left Bundle Branch Block Syndrome Successfully Treated With Left Bundle Branch Area Pacing

“…Favorable results of a physical exercise regimen and a blunting heart rate response to exercise with AV nodal blockers have been reported ( 3 , 4 ). Right ventricular pacing, biventricular pacemaker implantation, and more recently, cases of resolution of LBBB and associated symptoms with His bundle pacing (HBP) have been reported ( 1 , 5 , 6 , 7 ). Routine use of HBP may be limited due to higher capture thresholds at implantation and increased risk for late rise in HBP thresholds, necessitating lead revisions ( 8 ).…”