Recovery of Right Ventricular Apical Pacing-Induced Cardiomyopathy with Left Bundle Branch Pacing

Right ventricular pacing (RVP) is conventionally preferred in the treatment of patients with atrioventricular block. However, long-term RVP may result in pacing-induced cardiomyopathy (PICM) characterized by a new-onset or deterioration of ventricular functions because of dyssynchronous ventricular electrical activation, abnormal ventricular remodeling, and increased energy expenditure. Biventricular pacing (BVP) was the only treatment option in PICM besides guideline-directed medical therapy. However, conduction system pacing including left bundle branch area pacing (LBBaP) emerged and was adopted as the physiological alternative to BVP which showed promising results in terms of better electro-mechanical ventricular synchronization and hemodynamic parameters compared to BVP. Herein, we presented a patient from whom the PICM was recovered shortly after LBBaP.