Key result
A patient with ostium secundum ASD and high-grade AV block exhibited a right bundle branch block pacing pattern on surface ECG despite right ventricular pacing.
Case Report (n=1)
No
This case highlights diagnostic clues on surface ECG for differentiating right bundle branch block pacing patterns during right ventricular pacing, which can mimic malpositioned left ventricular pacing.
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Unexpected RBBB ECG pattern during RV pacing may signal ASD; case report leaves open mechanistic validation and diagnostic criteria refinement.
The present case report describes a patient with ostium secundum ASD with symptomatic high grade AV block , who underwent pacemaker implantation and whose post procedure surface ECG was suggestive of malpositioned left ventricular pacing after temporary as well as permanent pace maker implantation. Diagnostic clues on surface ECG for differentiating right bundle branch block pacing pattern with left ventricular as well as right ventricular pacing are thoroughly revisited and discussed in this article. To the best of our knowledge this is probably the first case report from India whereby right bundle branch block pacing pattern (complicated and uncomplicated) with right ventricular pacing in a single patient has been observed.
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Ruhela et al. (2013) conducted a case report in Ostium secundum ASD with symptomatic high grade AV block (n=1). Pacemaker implantation with right ventricular pacing was evaluated. A patient with ostium secundum ASD and high-grade AV block exhibited a right bundle branch block pacing pattern on surface ECG despite right ventricular pacing.
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