Khalil, B.Türkkan, C.2026-02-152026-02-1520262666-084910.1016/j.jaccas.2026.1069252-s2.0-105028628366https://doi.org/10.1016/j.jaccas.2026.106925https://hdl.handle.net/20.500.14517/8808Background: Left bundle branch block (LBBB) is generally considered irreversible and is associated with increased heart failure progression and mortality, particularly if associated with coronary diseases. Case Summary: An 81-year-old woman with prior coronary artery bypass graft and coronary stents presented with exertional angina, LBBB (QRS 148 ms), and ejection fraction (EF) 35%. Coronary angiography revealed left anterior descending stenosis and left circumflex artery restenosis. Following percutaneous coronary intervention (PCI; left anterior descending artery [LAD] stenting, left circumflex artery percutaneous coronary angioplasty), QRS decreased to 118 ms, and EF improved to 40% by 1 month. By 6 months, LBBB resolved, QRS normalized (88 ms), and EF recovered to 60%, sustained at 12 months (QRS 84 ms, EF 60%). Discussion: While LBBB is considered irreversible, the REVIVED-BCIS2 trial questions PCI benefits in severe ischemic left ventricular dysfunction. This case contrasts, showing complete LBBB resolution and left ventricular recovery post-LAD PCI, highlighting a rare instance of reversible ischemia-related conduction disease. Novelty: To the best of our knowledge, this is the first reported experience of complete LBBB resolution with full EF recovery after LAD PCI. Take-Home Message: Careful evaluation is needed to identify patients in whom ischemia-related conduction disease and left ventricular dysfunction may be reversible. © 2026 The Authorseninfo:eu-repo/semantics/openAccessCoronary Artery DiseaseIschemic Heart DiseaseLeft Bundle Branch BlockLeft Ventricular DysfunctionPercutaneous Coronary InterventionPercutaneous Coronary RevascularizationArticle