When Trabeculations Disrupt Conduction: Left Ventricular Noncompaction Presenting With Symptomatic Bradycardia and Isorhythmic Dissociation

ABSTRACT In young patients with unexplained symptomatic bradycardia, LVNC should be considered even when initial echocardiography is equivocal. Precise ECG interpretation is essential—AV dissociation driven by a ventricular escape rhythm must be distinguished from true AV block, as this distinction directly determines whether cardiac MRI, genetic evaluation, or device therapy is warranted.