Acute chest pain in a patient with left bundle branch pacing

Joseph Allencherril, Salman Bandeali, Kjell Nikus, Yochai Birnbaum

Research output: Contribution to journalArticlepeer-review


We present a patient with left bundle branch (LBB) electronic ventricular pacing with chest pain. ECG showed ventricular pacing and ST elevation in the inferolateral leads. At first it was felt that the Sgarbossa criteria for STEMI in electronic ventricular pacing are not met. However, as symptoms persisted, emergency coronary angiography was performed showing complete occlusion of the left circumflex artery. As LBB pacing results in narrow QRS complexes with incomplete right bundle branch block, ST-segment deviation should not be ignored and the Sgarbossa criteria for patients with LBB block or right ventricular electronic pacing should not be applied.

Original languageEnglish (US)
Pages (from-to)51-54
Number of pages4
JournalJournal of Electrocardiology
StatePublished - Mar 1 2023
Externally publishedYes


  • LBB pacing
  • ST elevation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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