Severe deterioration of left ventricular function after left bundle branch area pacing: A rare case report

Left bundle branch area pacing (LBBAP) has emerged as a promising alternative to conventional right ventricular pacing (RVP) and biventricular pacing (BVP), for treating patients with narrow QRS complexes 1. LBBAP provides physiological pacing by depolarizing ventricles via the Purkinje system, preserving cardiac electrical and mechanical synchrony, which is often disrupted with conventional pacing methods resulting in pacemaker induced cardiomyopathy (PICM)1. Several large observational studies have shown superior outcomes in reducing heart failure related hospitalizations and all-cause mortality for patients undergoing LBBAP vs RVP2,3.