Left bundle branch pacing with optimization of cardiac resynchronization treatment: A case report

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.