Key result
Right ventricular apical pacing resulted in a paced right bundle branch block QRS morphology at 2 months despite normal pacemaker function and no lead displacement.
Case Report (n=1)
This case demonstrates that a paced right bundle branch block (RBBB) QRS morphology after right ventricular apical pacing is not always indicative of lead displacement or malfunction.
Paced RBBB after RV apical pacing does not invariably indicate malfunction; this case report leaves open its prevalence and mechanism.
A 74-year-old man with symptomatic complete heart block underwent right ventricular apical permanent pacemaker implantation. The postoperative ECG showed, as expected, completely paced left bundle branch block QRS morphology. However, at the 2-month follow-up examination, his ECG showed paced right bundle branch block (RBBB) QRS morphology, although the patient was asymptomatic. On evaluation, pacemaker functioning was normal with no evidence of lead displacement. This case report highlights that RBBB morphology of paced QRS complex is not always a red flag sign.
No takes yet. Share an insight, caveat, or question.
Rajesh et al. (2014) conducted a case report in Symptomatic complete heart block (n=1). Right ventricular apical permanent pacemaker implantation was evaluated on QRS morphology on ECG. Right ventricular apical pacing resulted in a paced right bundle branch block QRS morphology at 2 months despite normal pacemaker function and no lead displacement.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: