Acute chest pain in a patient with left bundle branch pacing

Joseph Allencherril; Salman Bandeali; Kjell Nikus; Yochai Birnbaum

doi:10.1016/j.jelectrocard.2022.12.006

Acute chest pain in a patient with left bundle branch pacing

J Electrocardiol. 2023 Mar-Apr:77:51-54. doi: 10.1016/j.jelectrocard.2022.12.006. Epub 2022 Dec 27.

Authors

Joseph Allencherril¹, Salman Bandeali¹, Kjell Nikus², Yochai Birnbaum³

Affiliations

¹ Texas Heart Institute, Houston, TX, USA.
² Heart Center, Tampere University Hospital, and Faculty of Medicine and Health Technology, Tampere University, Finland.
³ Texas Heart Institute, Houston, TX, USA; The Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA. Electronic address: ybirnbau@bcm.edu.

PMID: 36630823
DOI: 10.1016/j.jelectrocard.2022.12.006

Abstract

We present a patient with left bundle branch (LBB) electronic ventricular pacing with chest pain. ECG showed ventricular pacing and ST elevation in the inferolateral leads. At first it was felt that the Sgarbossa criteria for STEMI in electronic ventricular pacing are not met. However, as symptoms persisted, emergency coronary angiography was performed showing complete occlusion of the left circumflex artery. As LBB pacing results in narrow QRS complexes with incomplete right bundle branch block, ST-segment deviation should not be ignored and the Sgarbossa criteria for patients with LBB block or right ventricular electronic pacing should not be applied.

Keywords: LBB pacing; ST elevation; STEMI.

Publication types

Case Reports

MeSH terms

Bundle of His
Bundle-Branch Block / complications
Bundle-Branch Block / diagnosis
Bundle-Branch Block / therapy
Cardiac Pacing, Artificial / methods
Chest Pain / diagnosis
Chest Pain / etiology
Electrocardiography* / methods
Heart Conduction System
Humans
Ventricular Septum*