{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T16:14:50Z","timestamp":1777652090194,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Painful left bundle branch block (PLBBB) syndrome remains a poorly understood cardiac anomaly. This systematic review consolidates case report evidence to elucidate effective management strategies and patient outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Databases including PubMed, Scopus, Web of Science, and Scielo were searched without restrictions on language or publication date. Following PRISMA guidelines, 128 articles were identified, with 31 meeting inclusion criteria. Data were extracted on patient demographics, clinical presentation, treatment regimens, and outcomes using Microsoft Excel and assessed for bias with the Joanna Briggs Institute's tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analysis included 45 patients with a mean age of 55.46 \u00b1 12.23. Predominantly, LBBB episodes occurred during exercise (73.3%). Initial treatments comprised beta\u2010blockers\/calcium channel blockers (55.56%), pacemaker implantation (13.3%), antianginal medications (13.3%), and other modalities (17.7%). Refractoriness to initial treatment was observed in 66.7% of patients, with subsequent pacemaker implantation resolving symptoms in most cases. An overall satisfactory response was seen in 73.3% of patients post\u2010treatment adjustments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The diverse approaches in treatment highlight the necessity for tailored therapeutic strategies. While pacemakers have demonstrated efficacy in controlling symptoms in several reported cases, it is essential to recognize the complex nature of this intervention. Pacemaker implantation, being a surgical procedure, carries long\u2010lasting implications for patients. Hence, the continuation of pharmacological treatments might still be preferable until more definitive research is available. This review emphasizes the urgent need for further research to establish evidence\u2010based guidelines, particularly concerning the selection of first line of treatment, to optimize outcomes for PLBBB syndrome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pace.15156","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T16:10:21Z","timestamp":1738858221000},"page":"343-350","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Painful Left Bundle Branch Block Syndrome: A Systematic Review of Treatment Strategies in Case Reports"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0428-0305","authenticated-orcid":false,"given":"Rodrigo Rufino Pereira","family":"Silva","sequence":"first","affiliation":[{"name":"Division of Cardiology Pronto Socorro Cardiol\u00f3gico de Pernambuco Prof. Luiz Tavares (PROCAPE) \u2013 Universidade de Pernambuco (UPE)  Recife 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