ArticleFrontiers in physiology2026
Case Report: Integrated cardiovascular and respiratory training as a novel therapeutic approach in a case of painful left bundle branch block.
Article in Frontiers in physiology, 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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Abstract
Background: Left bundle branch block (LBBB) is a heart rate (HR)-dependent cardiac conduction disorder that may occur in the absence of structural heart disease and can be associated with painful episodes. Evidence supporting exercise-based interventions in this setting is limited. We report the case of a 41-year-old woman with paroxysmal, painful LBBB, with onset occurring marginally above resting HR. Methods: After a diagnostic evaluation demonstrating preserved biventricular function, absence of myocardial ischemia, and normal hemodynamic responses, a 10-month supervised training program was implemented in three sequential phases: (1) diaphragmatic breathing exercise; (2) aerobic exercise performed below the individual LBBB HR threshold; (3) interval and steady-state aerobic exercise prescribed according to individually determined ventilatory thresholds (VT1 and VT2). Resting HR, HR at LBBB onset, maximal oxygen consumption (V˙O Results: After training, resting HR decreased by 15 bpm, while HR at LBBB onset increased by 50 bpm, markedly expanding the safe exertional window. V˙O Conclusions: This case suggests that a tailored respiratory and aerobic training program may safely improve cardiovascular efficiency, functional capacity, and symptom control in a patient with painful, HR-dependent LBBB. Individualized exercise training may represent a non-invasive adjunct or alternative to pharmacological or pacing strategies in selected patients.
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