A Case Report: Electrotonic Modulation‐Related T‐Wave Over‐Sensing After Left Bundle Branch Pacing

ABSTRACT A 66‐year‐old male patient diagnosed with dilated cardiomyopathy, heart failure with reduced EF (32%), and complete left bundle branch block (CLBBB) received cardiac resynchronization therapy (CRT)‐D implantation. Left bundle branch pacing (LBBP) was successfully performed, but during the f...

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Main Authors: Linlin Li, Manxin Lin, Jincun Guo, Qiang Li, Fanqi Meng, Xinyi Huang, Simei Chen, Binni Cai
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Annals of Noninvasive Electrocardiology
Subjects:
Online Access:https://doi.org/10.1111/anec.70083
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author Linlin Li
Manxin Lin
Jincun Guo
Qiang Li
Fanqi Meng
Xinyi Huang
Simei Chen
Binni Cai
author_facet Linlin Li
Manxin Lin
Jincun Guo
Qiang Li
Fanqi Meng
Xinyi Huang
Simei Chen
Binni Cai
author_sort Linlin Li
collection DOAJ
description ABSTRACT A 66‐year‐old male patient diagnosed with dilated cardiomyopathy, heart failure with reduced EF (32%), and complete left bundle branch block (CLBBB) received cardiac resynchronization therapy (CRT)‐D implantation. Left bundle branch pacing (LBBP) was successfully performed, but during the follow‐up 6 weeks later, the electrocardiogram (ECG) showed a sinus rhythm tracked by ventricular pacing with a ratio of approximately 2:1 due to T‐wave over‐sensing, which might be caused by the changes in T‐wave morphology due to electrotonic modulation and hyperkalemia or by the lower sensitivity threshold set by the auto sensing algorithm of the ICD. Shortening post‐ventricular atrial refractory period (PVARP) restored the ventricular pacing tracking of the atrium, and the T‐wave changes improved as time went by.
format Article
id doaj-art-7bde2ee758474ea5a0657556f5a86d8e
institution DOAJ
issn 1082-720X
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language English
publishDate 2025-05-01
publisher Wiley
record_format Article
series Annals of Noninvasive Electrocardiology
spelling doaj-art-7bde2ee758474ea5a0657556f5a86d8e2025-08-20T03:12:35ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2025-05-01303n/an/a10.1111/anec.70083A Case Report: Electrotonic Modulation‐Related T‐Wave Over‐Sensing After Left Bundle Branch PacingLinlin Li0Manxin Lin1Jincun Guo2Qiang Li3Fanqi Meng4Xinyi Huang5Simei Chen6Binni Cai7Division of Cardiology, Xiamen Cardiovascular Hospital Xiamen University Xiamen Fujian ChinaDivision of Cardiology, Xiamen Cardiovascular Hospital Xiamen University Xiamen Fujian ChinaDivision of Cardiology, Xiamen Cardiovascular Hospital Xiamen University Xiamen Fujian ChinaDivision of Cardiology, Xiamen Cardiovascular Hospital Xiamen University Xiamen Fujian ChinaDivision of Cardiology, Xiamen Cardiovascular Hospital Xiamen University Xiamen Fujian ChinaDivision of Echocardiography, Xiamen Cardiovascular Hospital Xiamen University Xiamen Fujian ChinaDivision of Cardiac Function, Xiamen Cardiovascular Hospital Xiamen University Xiamen Fujian ChinaDivision of Cardiology, Xiamen Cardiovascular Hospital Xiamen University Xiamen Fujian ChinaABSTRACT A 66‐year‐old male patient diagnosed with dilated cardiomyopathy, heart failure with reduced EF (32%), and complete left bundle branch block (CLBBB) received cardiac resynchronization therapy (CRT)‐D implantation. Left bundle branch pacing (LBBP) was successfully performed, but during the follow‐up 6 weeks later, the electrocardiogram (ECG) showed a sinus rhythm tracked by ventricular pacing with a ratio of approximately 2:1 due to T‐wave over‐sensing, which might be caused by the changes in T‐wave morphology due to electrotonic modulation and hyperkalemia or by the lower sensitivity threshold set by the auto sensing algorithm of the ICD. Shortening post‐ventricular atrial refractory period (PVARP) restored the ventricular pacing tracking of the atrium, and the T‐wave changes improved as time went by.https://doi.org/10.1111/anec.70083cardiac resynchronization therapy (CRT)left bundle branch pacingT‐wave oversensing
spellingShingle Linlin Li
Manxin Lin
Jincun Guo
Qiang Li
Fanqi Meng
Xinyi Huang
Simei Chen
Binni Cai
A Case Report: Electrotonic Modulation‐Related T‐Wave Over‐Sensing After Left Bundle Branch Pacing
Annals of Noninvasive Electrocardiology
cardiac resynchronization therapy (CRT)
left bundle branch pacing
T‐wave oversensing
title A Case Report: Electrotonic Modulation‐Related T‐Wave Over‐Sensing After Left Bundle Branch Pacing
title_full A Case Report: Electrotonic Modulation‐Related T‐Wave Over‐Sensing After Left Bundle Branch Pacing
title_fullStr A Case Report: Electrotonic Modulation‐Related T‐Wave Over‐Sensing After Left Bundle Branch Pacing
title_full_unstemmed A Case Report: Electrotonic Modulation‐Related T‐Wave Over‐Sensing After Left Bundle Branch Pacing
title_short A Case Report: Electrotonic Modulation‐Related T‐Wave Over‐Sensing After Left Bundle Branch Pacing
title_sort case report electrotonic modulation related t wave over sensing after left bundle branch pacing
topic cardiac resynchronization therapy (CRT)
left bundle branch pacing
T‐wave oversensing
url https://doi.org/10.1111/anec.70083
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