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- Title
Stymulacja lewej odnogi pęczka Hisa jako alternatywne leczenie zespołu preekscytacji.
- Authors
Kulpecki, Michał; Janicka-Pacyna, J.; Sałek, M.; Buksińska-Lisik, M.
- Abstract
Left bundle branch pacing (LBBP) is a relatively new, physiological pacing technique which resolves many problems faced by former cardiac pacing methods. This case report documents a therapeutic strategy in a 28-year-old female patient with preexcitation, reffered to our institution after two unsuccessful ablations of accessory pathways, complicated by intermittent third-degree atri-oventricular block. The patient was symptomatic and had syncope while hospitalized. Performed electrocardiogram showed preexcitation with PQ interval of 100 ms, besides complete AV block. Additional laboratory and imaging studies revealed no significant abnormalities. Reversible causes of cardiac arrhythmias were also excluded. The patient underwent implantation of dual-chamber pacemaker with correct intraoperative stimulation parameters. Selective LBB capture was confirmed through the use of electrophysiology unit. Through the use of ventricular pacing, we observed an abolition of preexcitation characteristics in the ECG. Further configured DDD type pacing with AV delay set at 100 ms, continued to achieve the absence of preexcitation. In echocardiographic verification of mitral inflow in relation to own rhythm, there were only slight hemodynamic changes noted. To provide stabilization of the patient's condition, the subsequent pharmacotherapy included metoprolol and flecainide. CONCLUSIONS Left bundle branch pacing allows elimination of preexcitation symptoms while preserving the hemodynamic heart function.
- Subjects
POLAND; WOLFF-Parkinson-White syndrome treatment; WOLFF-Parkinson-White syndrome; METOPROLOL; CONFERENCES &; conventions; INTRAOPERATIVE monitoring; ELECTROCARDIOGRAPHY; FLECAINIDE; CARDIAC pacing; CARDIAC pacemakers; ELECTROPHYSIOLOGY
- Publication
Polish Heart Journal / Kardiologia Polska, 2024, Vol 82, p52
- ISSN
0022-9032
- Publication type
Article