Published online Sep 26, 2020. doi: 10.12998/wjcc.v8.i18.4266
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
Cardiac resynchronization therapy (CRT) is a well-established therapy for patients with cardiomyopathy.
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.
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.