Acute myocardial infarction is mostly caused by coronary atherosclerotic stenosis or thrombosis. Myocardial infarction directly caused by left fascicular pacing is rarely reported.We reported a 60-year-old male patient who accepted left bundle branch pacing (LBBP). After operation, this patient experienced acute myocardial infarction (AMI), Adams-stokes syndrome and was treated successfully at last.