Postoperative rate induced left bundle branch block after craniotomy

Rate induced left bundle branch block [LBBB] is a rare peri-operative phenomenon. We encountered rate related LBBB in a 72 year old patient who had undergone a craniotomy. Acute coronary event was ruled out by doing serial troponin-I levels and absence of new onset regional wall motion abnormalities on echocardiogram. The electrocardiographic changes reverted to normal after controlling the rate with beta blockers. Further cardiac evaluation was advised but the patient and family opted for a conservative medical management considering his age and co-morbidities