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

نویسندگان

  • Hidekazu Tanaka
  • Mana Hiraishi
  • Tatsuya Miyoshi
  • Takayuki Tsuji
  • Akihiro Kaneko
  • Keiko Ryo
  • Kohei Yamawaki
  • Yuko Fukuda
  • Kazuko Norisada
  • Kazuhiro Tatsumi
  • Kensuke Matsumoto
  • Hiroya Kawai
  • Ken-ichi Hirata
چکیده

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.

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عنوان ژورنال:

دوره 9  شماره 

صفحات  -

تاریخ انتشار 2011