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April 18, 2026Heart Views0 citationsOpen Access

Alternating Right and Left Bundle Branch Block: Management in a Patient with Cardiac Amyloidosis

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ADA. DarshniMPMohammad Paymard

Key Result

Dual-chamber permanent pacemaker implantation was utilized to manage transient alternating right and left bundle branch block in a 74-year-old male with cardiac amyloidosis.

Key Points

  • To review the management strategies for alternating bundle branch block in a patient with cardiac amyloidosis.
  • Presented a case study of a 74-year-old male with cardiac amyloidosis.
  • Monitored the patient with serial electrocardiograms to observe the alternation of RBBB and LBBB.
  • Performed dual-chamber permanent pacemaker implantation as a management strategy.
  • The patient exhibited transient alternating RBBB and LBBB on ECG.
  • Successful management included the implantation of a dual-chamber permanent pacemaker.
  • The case underlines the challenges in treating conduction disease associated with cardiac amyloidosis.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
74-year-old male with known cardiac amyloidosis presenting with alternating bundle branch block (ABBB) in the context of an accidental fall
I
Intervention
Dual-chamber permanent pacemaker implantation

This case highlights the complexities of managing alternating bundle branch block and conduction disease with permanent pacing in patients with cardiac amyloidosis.

Abstract

Alternating bundle branch block (ABBB) is a phenomenon described by the presence of both right bundle branch block (RBBB) and left bundle branch block (LBBB) in the same individual at different points in time. We present the case of a 74-year-old male with known cardiac amyloid who was managed in hospital for an ABBB in the context of an accidental fall. Serial electrocardiograms (ECGs) revealed transient alternating RBBB and LBBB. The patient underwent dual-chamber permanent pacemaker implantation. This case reviews the management of alternating bundle brunch blocks and highlights the complexities of treating conduction disease in patients with cardiac amyloid.

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Cite This Study

Darshni et al. (2025) conducted a case report in Alternating bundle branch block and cardiac amyloidosis (n=1). Dual-chamber permanent pacemaker implantation was evaluated. Dual-chamber permanent pacemaker implantation was utilized to manage transient alternating right and left bundle branch block in a 74-year-old male with cardiac amyloidosis.

synapsesocial.com/papers/69e3207940886becb653f819https://doi.org/10.4103/heartviews.heartviews_91_25
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