ArticleJACC. Case reports2026
Myocardial Infarction in a Patient With Left Bundle Branch Pacing.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
backgroundA pacing rhythm can delay the diagnosis of acute myocardial infarction. CASE SUMMARY: A patient with chest pain and left bundle branch pacing (LBBP) was admitted to the emergency department. His subsequent electrocardiogram did not show dynamic ST-segment changes but a decrease in QRS amplitude in the anterior wall. Emergency angiography showed total occlusion of the proximal left anterior descending artery. DISCUSSION: This case highlights that in patients with chest pain and LBBP: 1) dynamic ST-segment changes may be absent even in the setting of total coronary occlusion; 2) dynamic QRS amplitude reduction can be a critical sign of ongoing myocardial ischemia and infarction; and 3) emergency angiography is warranted when angina cannot be relieved despite drug therapy, even if ST-T changes are absent. TAKE-HOME MESSAGES: In patients with chest pain and LBBP, a dynamic decrease in QRS amplitude should be considered as significant as ST-segment deviation. Emergency coronary angiography is crucial for timely intervention, especially when patients' symptoms persist.
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