Impact of Pulmonary Vein Isolation on Left Bundle Branch Block Following Tachycardia-induced Cardiomyopathy in a Patient with Persistent Atrial Fibrillation

Abstract

A 61-year-old man was referred to our hospital with exertional dyspnea. Electrocardiography showed atrial fibrillation (AF) with a heart rate of 116 bpm and left bundle branch block (LBBB). Chest radiography demonstrated pulmonary congestion and cardiomegaly with a cardiothoracic ratio of 57%. Transthoracic echocardiography revealed a severely reduced left ventricular systolic function (ejection fraction: 32%), suggesting tachycardia-induced cardiomyopathy (TIC) due to AF. Following treatment for congestive heart failure and complete isolation of each pulmonary vein, the LBBB disappeared, with a complete recovery of the cardiac systolic function. This report describes a case of transient reversible LBBB associated with systolic dysfunction treated with catheter ablation.