Case report reveals how His bundle pacing improved ECG diagnosis of myocardial infarction, suggesting it aids in diagnostic clarity.
Right ventricular pacing is considered a non-physiological modality; the wavefront of depolarization slowly spreads from the lead tip to the rest of the myocardium, creating morphological alterations of the QRS complexes that make it difficult an electrocardiographic diagnosis of myocardial infarction. During His bundle pacing the electrical impulse travels through the normal conduction system, as a result, paced ventricular complexes show morphological features that are completely superimposable to basal ECG. This peculiarity allows to appreciate the electrocardiographic alterations consequent to a previous heart attack or to an acute coronary syndrome. Below, we introduce a clinical case of PMK recipient in which the upgrade to HB pacing unmasked a previous infero-lateral myocardial infarction.
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Leonardo Marinaccio (2022) studied this question.
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