European heart journal. Case reports · 2026
Left ventricular outflow tract obstruction following left bundle branch area pacing: a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lian Xiaoming, Yang Xiao-Min, Zhang Rui, Liu Bo, Li Yigang
Аннотация
BACKGROUND: Left bundle branch area pacing (LBBAP) is a physiological pacing strategy considered safe in non-obstructive hypertrophic cardiomyopathy (HCM). Its effect on left ventricular outflow tract (LVOT) obstruction in anatomically predisposed patients remains unclear.
CASE SUMMARY: A 76-year-old woman underwent LBBAP for atrioventricular nodal dysfunction. One week later, she developed chest pain and elevated troponin, despite unobstructed coronaries. Echocardiography revealed a resting LVOT gradient of 112.6 mmHg. Bipolar low-voltage pacing worsened the gradient, while unipolar high-voltage pacing reduced it to 15 mmHg, with symptom relief and improved global longitudinal strain.
DISCUSSION: This case illustrates a rare interaction between pacing configuration and LVOT dynamics. It emphasizes the need to recognize pacing-induced obstruction, particularly in patients with septal hypertrophy or mitral anomalies, and to adjust programming accordingly.
CASE SUMMARY: A 76-year-old woman underwent LBBAP for atrioventricular nodal dysfunction. One week later, she developed chest pain and elevated troponin, despite unobstructed coronaries. Echocardiography revealed a resting LVOT gradient of 112.6 mmHg. Bipolar low-voltage pacing worsened the gradient, while unipolar high-voltage pacing reduced it to 15 mmHg, with symptom relief and improved global longitudinal strain.
DISCUSSION: This case illustrates a rare interaction between pacing configuration and LVOT dynamics. It emphasizes the need to recognize pacing-induced obstruction, particularly in patients with septal hypertrophy or mitral anomalies, and to adjust programming accordingly.