Safe right bundle branch block pattern during permanent right ventricular pacing: a case report.

Abstract

We present the case of a 72-year-old male who underwent a permanent transvenous DDD pacemaker implantation for symptomatic complete heart block. The postoperative surface electrocardiogram (ECG) revealed a right bundle branch block (RBBB) pacing pattern with transition in lead V3 and left bundle branch block (LBBB) in D1, suggesting a malpositioned ventricular lead in the left heart. Malposition of a lead was ruled out by chest X-ray and echocardiogram confirming apical right ventricular pacing. After a literature review, a surface ECG maneuver, by placing leads V1 and V2 one intercostal space lower, restored the usual patterns of paced LBBB pattern. We discuss the literature concerning safe-paced RBBB.

• Authors: Abdelkarim Errahmouni, Jean Christophe Charniot, Jean Yves Artigou
• Journal: Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir (Turk Kardiyol Dern Ars) Vol. 41 Issue 6 Pg. 522-5 (Sep 2013) ISSN: 1016-5169 [Print] Turkey
• PMID: 24104978 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Bundle-Branch Block (diagnosis, physiopathology)
• Cardiac Pacing, Artificial
• Electrocardiography
• Humans
• Male
• Pacemaker, Artificial