Improvement of Dyssynchrony with Left Bundle Branch Pacing and Evaluation by Echocardiography Using an Image Analysis System（TomTec-Arena）

Abstract

Cardiac resynchronization therapy（CRT）has been used in patients with heart failure with intraventricular conduction delay, but left bundle branch pacing, which can provide physiological contraction through the native stimulatory conduction pathway, has attracted attention recently as a newer modality. The case described here was an 86-year-old male. He came to our hospital after suffering shorthness of breath for several days. His ECG showed complete left bundle branch block（LBBB, QRS duration of 146 msec）and echocardiogram showed dyssynchrony. The patient was diagnosed with heart failure due to significant pulmonary congestion, but his subsequent treatment was poor. We report here a case of shortened QRS width, improved dyssynchrony, and recovery of cardiac function after left branch bundle pacing. In this case, we report the use of TomTec-Arena, a new evaluation method for dyssynchrony.