Acute myocardial infarction in a patient with permanent left bundle branch pacing

Abstract

Background: Electrocardiographic diagnosis of acute myocardial infarction in the setting of cardiac pacing represents diagnostic challenge. There are no focusing data, neither reporting about diagnostic sensitivity of 12‑lead ECG with left bundle branch area pacing (LBBAP) during acute myocardial infarction (AMI).

Case summary: We present 12‑lead ECG morphology in a patient with permanent LBBAP during AMI.

Discussion: Abnormal repolarization changes induced by ventricular pacing can lead to delay in diagnosis in patients with AMI. LBBAP and overall conduction system pacing may facilitate a timely diagnosis providing additional, still underestimated, advantages of physiological pacing of the heart.

Keywords: Acute myocardial infarction; Conduction system pacing; ECG; Left bundle branch area pacing.