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Exercise-induced left bundle branch block and subsequent mechanical left ventricular dyssynchrony--resolved with pharmacological therapy.

ABSTRACT: A 53-year-old man with depressed ejection fraction (EF) of 35% and QRS width of 88 ms at rest was admitted to our institution with a complaint of exertional chest discomfort and dyspnea. During treadmill exercise, left bundle-branch block (LBBB) with a QRS width of 152 ms occurred at a heart rate of 100 bpm. During LBBB, the patient showed significant mechanical dyssynchrony as evidenced by a two-dimensional speckle tracking radial strain of 260 ms (? 130 ms), defined as the time difference between anterior-septum and posterior wall. Five-month after carvedilol and candesartan administration, EF had improved to 49% and LBBB did not occur until a heart rate of 126 bpm was attained during treadmill exercise. It appears that pharmacological therapy may be useful for patients with heart failure and exercise-induced LBBB.

SUBMITTER: Tanaka H 

PROVIDER: S-EPMC3044107 | biostudies-literature | 2011

REPOSITORIES: biostudies-literature

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Exercise-induced left bundle branch block and subsequent mechanical left ventricular dyssynchrony--resolved with pharmacological therapy.

Tanaka Hidekazu H   Hiraishi Mana M   Miyoshi Tatsuya T   Tsuji Takayuki T   Kaneko Akihiro A   Ryo Keiko K   Yamawaki Kohei K   Fukuda Yuko Y   Norisada Kazuko K   Tatsumi Kazuhiro K   Matsumoto Kensuke K   Kawai Hiroya H   Hirata Ken-ichi K  

Cardiovascular ultrasound 20110207 1

A 53-year-old man with depressed ejection fraction (EF) of 35% and QRS width of 88 ms at rest was admitted to our institution with a complaint of exertional chest discomfort and dyspnea. During treadmill exercise, left bundle-branch block (LBBB) with a QRS width of 152 ms occurred at a heart rate of 100 bpm. During LBBB, the patient showed significant mechanical dyssynchrony as evidenced by a two-dimensional speckle tracking radial strain of 260 ms (≥ 130 ms), defined as the time difference betw  ...[more]

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