Key result
Uncomplicated right ventricular outflow tract pacing resulted in an unexpected right bundle branch block pattern in an 18-year-old female with corrected tetralogy of Fallot.
Case Report (n=1)
An RBBB pattern can occur after uncomplicated right ventricular outflow tract pacing in patients with specific congenital heart anatomies, mimicking lead malposition.
RBBB after uncomplicated RVOT pacing may not indicate malposition in corrected TOF; hypothesis-generating for congenital anatomies.
Usually an electrocardiogram after right ventricular (RV) pacing should yield left bundle branch block (LBBB) pattern. However, the presence of right bundle branch block (RBBB) pattern after pacemaker implantation should alert the physician to a malposition of lead. We report a case of 18-year-old female who underwent dual chamber pacemaker implantation and had RBBB pattern post implantation. Detailed evaluation revealed an uncomplicated right ventricular outflow tract pacing. The possible causes of this abnormal pattern after an uncomplicated RV pacing are also reviewed.
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Gupta et al. (2017) conducted a case report in Corrected tetralogy of Fallot with left sided superior vena cava (n=1). Dual chamber pacemaker implantation with right ventricular outflow tract pacing was evaluated on Electrocardiogram pattern post implantation. Uncomplicated right ventricular outflow tract pacing resulted in an unexpected right bundle branch block pattern in an 18-year-old female with corrected tetralogy of Fallot.
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