Prolonging the atrioventricular delay from 150 ms to 250 ms during left bundle branch area pacing reduced the left ventricular outflow tract gradient from 120 mmHg to 30 mmHg.
Case Report (n=1)
No
Does intentional atrioventricular dyssynchrony resolve LBBAP-induced LVOT obstruction?
Intentional AV dyssynchrony by prolonging the AV delay can effectively manage LBBAP-induced systolic anterior motion and LVOT obstruction.
Absolute Event Rate: 30% vs 120%
gradient with stepwise prolongation of AV delay from 100 ms to 250 ms. The final setting (AV delay 250 ms) results in near-complete resolution of dynamic LVOT obstruction. LBBAP, left bundle branch area pacing; AV, atrioventricular; LVOT, left ventricular outflow tract
Jeong et al. (2026) conducted a case report in First-degree atrioventricular block with intermittent high-grade block and latent LVOTO (n=1). Prolongation of atrioventricular (AV) delay vs. AV delay 150 ms was evaluated on Left ventricular outflow tract (LVOT) gradient (mmHg). Prolonging the atrioventricular delay from 150 ms to 250 ms during left bundle branch area pacing reduced the left ventricular outflow tract gradient from 120 mmHg to 30 mmHg.