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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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