# Pacing-Induced Cardiomyopathy in a Transplanted Heart Treated With Left Bundle Branch Pacing

## TL;DR

A transplanted heart developed pacing-induced cardiomyopathy, which was successfully treated with left bundle branch pacing.

## Contribution

Demonstrates left bundle branch pacing as an effective treatment for pacing-induced cardiomyopathy in heart transplant recipients.

## Key findings

- Right ventricular pacing led to pacing-induced cardiomyopathy in a heart transplant patient.
- Left bundle branch pacing restored left ventricular function.
- Ventricular dyssynchrony from right ventricular pacing may increase PICM risk in OHT recipients.

## Abstract

Atrioventricular (AV) block is a potential complication of orthotropic heart transplantation (OHT). The optimal cardiac pacing method is largely unexplored in patients after OHT.

We present a patient with AV block after OHT in whom right ventricular pacing resulted in pacing-induced cardiomyopathy (PICM). Left ventricular function was restored with left bundle branch pacing.

AV block is an uncommon complication after OHT that requires ventricular pacing. Ventricular dyssynchrony induced by right ventricular pacing may be associated with increased risk for PICM in OHT recipients. Cardiac physiologic pacing should be considered as the primary pacing strategy in this population.

OHT recipients may be at increased risk for PICM. Left bundle branch pacing is an effective strategy for both prevention and treatment of PICM.