title: Interventricular cardiac resynchronization with right ventricular apical pacing in a patient with Ebstein's defect.
abstract: We present the case of a patient with Ebstein's defect surgically corrected, and a complete right bundle branch block (RBBB) documented on echocardiogram. After an episode of near syncope due to a high-grade atrioventricular (AV) block, the patient was assisted with a bicameral DDDR pacemaker implanted with traditional right ventricular apical pacing. After the DDDR, and after stimulation with an AV delay of 180 ms, a narrow QRS complex was observed. Meanwhile, the typical left bundle branch block morphology of the right ventricular pacing and the native RBBB morphology were missing. The QRS complex narrowing persisted, even with physical activity and also with the heart rate progression. An echocardiographic study confirmed an improvement of the cardiac resynchronization parameters with this programmed stimulation.
authors.affiliation: Division of Cardiology, Borgomanero Hospital, Novara, Italy. stemaffe@libero.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Maffe
authors.forename: Antonello
authors.initials: A
authors.lastname: Perucca
authors.forename: Paola
authors.initials: P
authors.lastname: Paffoni
authors.forename: Fabiana
authors.initials: F
authors.lastname: Signorotti
authors.forename: Nicolò Franchetti
authors.initials: NF
authors.lastname: Pardo
authors.forename: Pierfranco
authors.initials: P
authors.lastname: Dellavesa
authors.forename: Umberto
authors.initials: U
authors.lastname: Parravicini
authors.forename: Franco
authors.initials: F
authors.lastname: Zenone
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Paino
authors.forename: Massimo
authors.initials: M
authors.lastname: Bielli
authors.forename: Federico
authors.initials: F
authors.lastname: Carola
authors.forename: Marco
authors.initials: M
authors.lastname: Zanetta
mesh_terms: D054537:Atrioventricular Block / Q000628:therapy; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004437:Ebstein Anomaly / Q000601:surgery / Q000628:therapy*; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D008875:Middle Aged