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There are no clinical practice recommendations. 2. The Chair and Vice-Chair of the document are free of any relationships with industry and other entities (RWIs). 3. The remainder of the writing committee may have RWIs, with no dollar limit, but may not have relevant stock, stock options, equity, or royalties or be employed by industry. 4. The writing committee is encouraged to gain information from advisors. Advisors must be physicians or health care providers who are not able to serve as writing committee members because they have relevant stock, stock options, equity, or royalties. Advisors cannot be employed by industry and do not participate in writing. 5. The writing committee uses industry forums to engage representatives of industry, the U.S. Food and Drug

Chest pain in patients with left bundle branch block (LBBB) and normal coronaries has been reported previously in the literature. Prior cases of intermittent LBBB and "chest pain syndrome" are known of, but the causes of and treatment options for such remain unclear. A mechanism of myocardial dyssynchrony has been proposed as a possible cause of the pain, but this has not yet widely been investigated. The application of His-bundle pacing techniques to promote normal activation of the conduction system may be a treatment option. The function of cardiac implantable electronic devices can be followed via remote monitoring (RM), a vital tool in this unique patient population. The present report introduces the case of a 51-year-old female to highlight this under-recognized syndrome, including the pacing technologies used for treatment and the crucial role of RM follow-up in such affected individuals. KEYWORDS.Chest pain syndrome, His-bundle pacing, left bundle branch block, remote monitoring.

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