[Paced right bundle branch block: what to do?].
Left bundle branch block (LBBB) is the assumed presentation of right ventricular pacing. Paced right bundle branch block (RBBB) raises the suspicion of lead malposition. In a well placed right ventricular lead an atypical conduction pattern must be evoked. It is important to differentiate malposition from well placed ventricular lead because malposition is associated with embolic complications and may require therapeutic interventions including anticoagulation or radical lead replacement. We report the case of two patients with a paced RBBB pattern despite a well-placed right ventricular lead, as confirmed by chest X-ray and echocardiography. We discuss the etiologies and attitude to adopt when electrocardiogram (ECG) shows a paced RBBB.
Nkoulou
R
R
Service de cardiologie, HUG, 1211 Genève. nkoulou-rene@diogenes.hcuge.ch
Beauchet
O
O
Perrenoud
J J
JJ
D000369:Aged, 80 and over; D002037:Bundle-Branch Block / Q000209:etiology*; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects*; D004452:Echocardiography; D017097:Electric Impedance; D004562:Electrocardiography; D004868:Equipment Failure; D005260:Female; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects; D013902:Radiography, Thoracic