Left Bundle Branch Area Pacing as an alternative to His Bundle pacing
for Cardiac Resynchronization Therapy: a case report.
Abstract
Biventricular pacing (BVP) has been demonstrated to improve functional
outcomes and mortality of patients with symptomatic heart failure,
reduced LVEF and wide QRS. Unfortunately, difficult coronary sinus
anatomy can limit left ventricular lead placement. In such clinical
situation, His Bundle Pacing (HBP) and Left Bundle Branch Area Pacing
(LBBAP) have recently appeared as attractive alternatives to BVP. We
describe the case of a patient with an indication for Cardiac
Resynchronization Therapy (CRT) and AV node ablation, where left
ventricular lead implantation and corrective HBP failed. LBBAP allowed
for electrical and echocardiographic resynchronization with significant
functional improvement.