His-bundle pacing in a patient with dextrocardia, severe systolic dysfunction, and complete atrioventricular block Manuel Molina-Lerma, MD, Juan Jiménez-Jáimez,

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Presentation transcript:

His-bundle pacing in a patient with dextrocardia, severe systolic dysfunction, and complete atrioventricular block Manuel Molina-Lerma, MD, Juan Jiménez-Jáimez, MD, PhD, Rosa Macías-Ruiz, MD, Pablo Sánchez-Millán, MD, PhD, Luis Tercedor, MD, Miguel Álvarez, MD, PhD HeartRhythm Case Reports Volume 5, Issue 3, Pages 148-151 (March 2019) DOI: 10.1016/j.hrcr.2018.11.016 Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 1 A: The lower record shows the endocavitary signal sensed by electrode, showing the ventriculogram (V) and retrograde hisiogram (H). The upper records show the surface electrocardiogram (ECG). B: The top image shows the surface ECG; in the middle is the electrogram of the His-bundle electrode (EGM HIS); the bottom image shows the marker channel. Ap = auricular pacing; Vn = ventricular noise; Vr = ventricular refractory. HeartRhythm Case Reports 2019 5, 148-151DOI: (10.1016/j.hrcr.2018.11.016) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 2 A: Atrial fibrillation with ventricular rhythm paced from the right ventricle, QRS 210 ms. B: Selective His-bundle pacing with narrow QRS interval, QRS 116 ms. HeartRhythm Case Reports 2019 5, 148-151DOI: (10.1016/j.hrcr.2018.11.016) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 3 Chest radiograph: His-bundle electrode (HIS) above, right ventricular electrode (V) below. HeartRhythm Case Reports 2019 5, 148-151DOI: (10.1016/j.hrcr.2018.11.016) Copyright © 2018 Heart Rhythm Society Terms and Conditions