A case of pacing-induced cardiomyopathy dramatically reversed by left bundle branch pacing in one week

Right ventricular pacing is a traditional pacing modality for patients diagnosed with atrioventricular block. However, long-term right ventricular pacing may lead to pacing-induced cardiomyopathy (PICM) characterized by ventricular systolic dyssynchrony, deteriorative left ventricular systolic function, and symptoms of heart failure. It was reported that 10%–20% of patients have developed PICM after pacemaker implantation.1, 2, 3 Cardiac resynchronization therapy is the most common treatment for PICM, although it was reported with higher economic cost and uncertain prognosis.4 Recently, left bundle branch pacing (LBBP) has emerged as a novel physiological pacing modality and has been proposed as an alternative treatment for PICM.5 We present a case of PICM dramatically reversed by replacing the lead to the left bundle branch (LBB) region within 1 week.