Ferrara Martha G, Cappucci Roger V, Wang Daniel Y
White Plains Hospital Center, Montefiore Health System, White Plains, NY, USA.
J Innov Card Rhythm Manag. 2019 Sep 15;10(9):3810-3814. doi: 10.19102/icrm.2019.100906. eCollection 2019 Sep.
Chest pain in patients with left bundle branch block (LBBB) and normal coronaries has been reported previously in the literature. Prior cases of intermittent LBBB and "chest pain syndrome" are known of, but the causes of and treatment options for such remain unclear. A mechanism of myocardial dyssynchrony has been proposed as a possible cause of the pain, but this has not yet widely been investigated. The application of His-bundle pacing techniques to promote normal activation of the conduction system may be a treatment option. The function of cardiac implantable electronic devices can be followed via remote monitoring (RM), a vital tool in this unique patient population. The present report introduces the case of a 51-year-old female to highlight this under-recognized syndrome, including the pacing technologies used for treatment and the crucial role of RM follow-up in such affected individuals.
先前文献中已报道过左束支传导阻滞（LBBB）且冠状动脉正常的患者出现胸痛的情况。已知有间歇性LBBB和“胸痛综合征”的既往病例，但其病因和治疗选择仍不明确。已提出心肌不同步机制可能是疼痛的原因，但尚未对此进行广泛研究。应用希氏束起搏技术促进传导系统的正常激活可能是一种治疗选择。可通过远程监测（RM）跟踪心脏植入式电子设备的功能，这是该特殊患者群体的重要工具。本报告介绍了一名51岁女性的病例，以突出这种未得到充分认识的综合征，包括用于治疗的起搏技术以及RM随访在此类患者中的关键作用。
