Right ventricularly paced right bundle–type pattern on ECG: Does this preclude upgrading to biventricular pacing? Adrian H. Shandling, MD, FACC, Gregory.

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Presentation transcript:

Right ventricularly paced right bundle–type pattern on ECG: Does this preclude upgrading to biventricular pacing? Adrian H. Shandling, MD, FACC, Gregory S. Thomas, MD, MPH, FACC, MASNC HeartRhythm Case Reports Volume 4, Issue 7, Pages 298-300 (July 2018) DOI: 10.1016/j.hrcr.2018.03.010 Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 1 A “split screen” of the electrocardiogram from case 2 is displayed. Right ventricular pacing recorded with V1 electrode in the second interspace is on the left side of the figure; right ventricular pacing recorded with V1 electrode in the fifth interspace is seen on the right. The only manifest difference is in lead V1—the QRS complex is upright on the left panel, down-going in the right panel. HeartRhythm Case Reports 2018 4, 298-300DOI: (10.1016/j.hrcr.2018.03.010) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 2 A posteroanterior chest radiograph from case 2 is shown with 4 pacemaker leads. One lead is in the right atrium, 1 is in the coronary sinus, and 2 are in the right ventricle (RV). One RV lead is capped. The second RV lead is the thicker electrode and is active in the defibrillation and sensing systems. It is in an appropriate apical and septal position. HeartRhythm Case Reports 2018 4, 298-300DOI: (10.1016/j.hrcr.2018.03.010) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 3 A lateral chest radiograph from case 2 shows the defibrillator lead in the septal position. The coronary sinus lead can be seen posteriorly. HeartRhythm Case Reports 2018 4, 298-300DOI: (10.1016/j.hrcr.2018.03.010) Copyright © 2018 Heart Rhythm Society Terms and Conditions