Zhang DH, Lang MJ, Tang G, Chen XX, Li HF. Left bundle branch pacing with optimization of cardiac resynchronization treatment: A case report. World J Clin Cases 2020; 8(18): 4266-4271 [PMID: 33024788 DOI: 10.12998/wjcc.v8.i18.4266]
Corresponding Author of This Article
Ming-Jian Lang, MD, Doctor, Department of cardiovascular, Chengdu Fifth People's Hospital, No. 33 Mashi Street, Wenjiang District, Chengdu 611130, Sichuan Province, China. 64518190@qq.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 26, 2020; 8(18): 4266-4271 Published online Sep 26, 2020. doi: 10.12998/wjcc.v8.i18.4266
Left bundle branch pacing with optimization of cardiac resynchronization treatment: A case report
Deng-Hong Zhang, Ming-Jian Lang, Gang Tang, Xiao-Xiao Chen, Hong-Fei Li
Deng-Hong Zhang, Ming-Jian Lang, Gang Tang, Xiao-Xiao Chen, Hong-Fei Li, Department of Cardiovascular Medicine, Chengdu Fifth People's Hospital, Chengdu 611130, Sichuan Province, China
Author contributions: Zhang DH and Lang MJ performed the study, participated in collecting the data, and drafted the manuscript; Tang G and Chen XX performed the statistical analysis and participated in the study design; Li HF and Lang MJ helped in writing the manuscript; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ming-Jian Lang, MD, Doctor, Department of cardiovascular, Chengdu Fifth People's Hospital, No. 33 Mashi Street, Wenjiang District, Chengdu 611130, Sichuan Province, China. 64518190@qq.com
Received: April 8, 2020 Peer-review started: April 8, 2020 First decision: April 22, 2020 Revised: July 20, 2020 Accepted: July 30, 2020 Article in press: July 30, 2020 Published online: September 26, 2020 Processing time: 166 Days and 15.1 Hours
Abstract
BACKGROUND
Cardiac resynchronization therapy (CRT) is a well-established therapy for patients with cardiomyopathy.
CASE SUMMARY
The patient underwent left bundle branch area and left ventricular (reaching the left ventricular lateral vein through the coronary sinus) pacing. The optimal CRT was performed under the right bundle branch of the patient by adjusting the optimal a-v and v-v interphases to achieve the maximal benefit of the treatment.
CONCLUSION
The patient was diagnosed with left bundle branch block and heart failure. A left bundle branch area pacemaker assisted in correcting the complete left bundle branch block. However, the shorter QRS wave shape after pacemaker implantation through the left bundle branch area indicated a complete right bundle branch block pattern. Hence, the left bundle branch area pacemaker is not always considered as the optimal treatment. The left bundle branch pacing with the optimization of cardiac resynchronization treatment may serve as a new CRT strategy.
Core Tip: The traditional cardiac resynchronization therapy (CRT) method was not employed; rather the left bundle branch region was used for pacing. Then, the coronal sinus left ventricular wire was combined with the right bundle branch to fuse the down transmission, which significantly narrowed the electrocardiogram QRS and achieved the optimal effect of CRT.
