Normalization of the EKG in patients with right bundle branch block by Right ventricular pacing

  • Z Zainuddin Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia/National Cardiovascular Center Harapan Kita, Jakarta
  • Yoga Yuniadi Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia/National Cardiovascular Center Harapan Kita, Jakarta
  • Hardja Priatna Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia/National Cardiovascular Center Harapan Kita, Jakarta
  • Dicky A Hanafi Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia/National Cardiovascular Center Harapan Kita, Jakarta

Abstract

Right ventricle apex (RVA) pacing bypasses the His-Purkinje system result-ing in left bundle branch block like pattern on surface EKG. In preexisting right bundle branch block (RBBB), pacing from certain location of RV might change the EKG pattern. We present two cases of normalization of QRS complex upon RV septal pacing in preexisting RBBB patients. The postulated mechanisms of the phenomenon is also proposed.

Downloads

Download data is not yet available.

References

Albouaini K, Alkarni A, Mudawi T, Gamage MD, Wright DJ. Selective site right ventricular pacing. ?eart. 2009;95:2030-2039

Harris ZI, Gammage MD. Alternating right ventricular pacing sites – where are we going? Europace. 2000;2:93-98.

Scheffer M, Tanis GJ, van Mechlen R. Normalization of the ECG in a patient with right bundle branch block by cardiac pacing. Neth ?eart J. 2005;13:151-153.

Riedlbauchova L, Kautzner J, ?atala R, Buckingham TA. Is right ventricular outflow tract pacing an alternative to left ventricular/ biventricular pacing ? Pacing Clin Electrophysiol. 2004;27:871-877.

de Cock CC. Fifty years of cardiac pacing : the dark side of the moon ? Neth ?eart J 2008;16:S12-S14.

Wyman BT, ?unter WC, Prinzen FW. Mapping propagation of mechanical activation in the paced heart with MRI tagging. Am J Physiol. 1999;276:881-891.

Prinzen FW, ?unter WC, Wyman BT. Mapping of regional myocardial strain and work during ventricular pacing: experi-mental study using magnetic resonance imaging tagging. J Am Coll Cardiol. 1999;33:1735-1742.

Delhaas T, Arts T. Regional fibre stress-fibre strain area as an estimate of regional blood flow and oxygen demand in the canine heart. J Physiol 1994;477:481-496.

Giudici MC, Thornburg GA, Buck D. Comparison of right ventricle outflow tract and apical lead permanent pacing on cardiac output. Am J Cardiol. 1997;79:209-212.

Tse HF, Lau CP. Long term effect of the right ventricular pac-ing on myocardial perfusion and function. J Am Coll Cardiol .1997;29:744-749.

Tantengco MV, Thomas RL, Karpawich PP. Left ventricular dysfunction after long term right ventricular apical pacing in the young. J Am Coll Cardiol. 2001;37:2093-2100.

Johnson F, Jayesh B, Ashiskumar M, Faizal A, Mond ?. Right ventricular septal pacing: ?as it come of age ? Indian Pacing Electrophysiol J. 2010;10:69-72.

Tim JF, Cate T, Mike GS, George RS, Fred JV, Nobert MV?. Right ventricular outflow and apical pacing comparably worsen the echocardiographic normal left ventricle. Eur J Echo. 2007;9:672-677.

Richard J?, ?arry GM. Pacing the right ventricular outflow tract septum – Are we there yet ? Asia Pacific cardiol. 2007;1:57-59.

De Cock CC, Guidici MC, Twisk JW. Comparison of the haemodynamic effects of the right ventricular outflow-tract pacing with right ventricular apex pacing: a quantitive review. Europace. 2003;5:275-8.

Mond ?G, Gammage MD. Selective site pacing: The future of cardiac pacing ? Pacing Clin Electrophysiol. 2004;27:835-836.

Cassidy DM, Vassallo JA, Marchlinski FE, Buxton AE, Unter-eker WJ, Josphson ME. Endocardial mapping in humans in sinus rhytm with normal left ventricles : activation patterns and characteristics of electrograms. Circulation. 1984;70:37-42.
Views & Downloads
Abstract views: 412   
PDF downloads: 308   
How to Cite
Zainuddin, Z., Yuniadi, Y., Priatna, H., & Hanafi, D. (1). Normalization of the EKG in patients with right bundle branch block by Right ventricular pacing. Indonesian Journal of Cardiology, 31(3), 206-11. https://doi.org/10.30701/ijc.v31i3.134