JACC Case Rep. 2026 Jun 25:108999. doi: 10.1016/j.jaccas.2026.108999. Online ahead of print.
ABSTRACT
A 67-year-old man with recurrent syncope and chronic right bundle branch block underwent left bundle branch pacing for infra-Hisian atrioventricular block. Because a prior electrocardiogram showed a type 2 Brugada pattern, an ajmaline challenge was performed after device implantation using high-precordial lead positioning. The test unmasked a diagnostic type 1 Brugada pattern during both intrinsic and left bundle branch block-paced beats. This case illustrates that diagnostic Brugada repolarization abnormalities may remain recognizable despite altered ventricular activation associated with conduction system pacing.
PMID:42347725 | DOI:10.1016/j.jaccas.2026.108999