Safe right bundle branch block pattern during permanent right ventricular pacing

It is known that an electrocardiogram (ECG) after transvenous right ventricular (RV) pacing should yield left bundle branch block (LBBB) QRS patterns. When right bundle branch block (RBBB) pacing morphology appears in a patient with a permanent or temporary transvenous RV pacemaker, myocardial perfo...

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Bibliographic Details
Published inJournal of electrocardiology Vol. 36; no. 1; pp. 67 - 71
Main Authors Yang, Yung-Nien, Yin, Wei-Hsian, Young, Mason Shing
Format Journal Article
LanguageEnglish
Published Orlando, FL Elsevier Inc 01.01.2003
Philadelphia, PA Churchill Livingstone
Elsevier Science Ltd
Subjects
Aged
Biological and medical sciences
Bundle-Branch Block - diagnostic imaging
Bundle-Branch Block - etiology
Bundle-Branch Block - physiopathology
Diseases of the cardiovascular system
Echocardiography
Electrocardiography
Heart Block - therapy
Humans
Male
Medical sciences
Pacemaker, Artificial
pacing lead
Radiography
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
right bundle branch block
Ventricular pacing
Ventricular pacing
right bundle branch block
pacing lead
Human
Arrhythmia
Treatment efficiency
Instrumentation therapy
Cardiovascular disease
Exploration
Bundle branch block
Conduction disorder
Differential diagnostic
Case study
Electrodiagnosis
Instrumental stimulation
Treatment
Pacemaker
Heart disease
Heart block
Electrocardiography
Complication
Medical imagery
Diagnosis
Bibliographic review
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Summary:It is known that an electrocardiogram (ECG) after transvenous right ventricular (RV) pacing should yield left bundle branch block (LBBB) QRS patterns. When right bundle branch block (RBBB) pacing morphology appears in a patient with a permanent or temporary transvenous RV pacemaker, myocardial perforation or malposition of the pacing lead must be ruled out, even though the patient may be asymptomatic. We report a case of a 77-year-old man who underwent permanent transvenous VDD pacemaker implantation for symptomatic heart block. The postoperative ECG revealed a RBBB pacing configuration, but his chest X-ray and echocardiographic studies confirmed uncomplicated RV pacing. We review and discuss the literature concerning the differential diagnosis of such a safe RBBB ECG pattern.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
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ISSN:0022-0736
1532-8430
DOI:10.1054/jelc.2003.50002