title: Do patients with heart failure and right bundle branch block need biventricular pacing? A case of significant QRS narrowing by right ventricular pacing alone.
abstract: We report the case of a 56-year-old male with ischemic cardiomyopathy, severe left ventricular dysfunction and right bundle branch block (RBBB) with a wide QRS duration (180ms) who received dual-chamber implantable cardioverter-defibrillator for primary prevention of sudden death. After having placed the right ventricular lead in the middle of the inter-ventricular septum, a significant narrowing of QRS duration was observed, thus obtaining "de facto" a cardiac resynchronization therapy (CRT). This type of cardiac pacing could be an alternative to conventional CRT with left ventricular pacing in patients with wide QRS due to RBBB. The long-term effects of this RV only pacing strategy with ICD in patients with heart failure yet remain to be determined.
authors.affiliation: Department of Clinical and Experimental Medicine and Unità di Terapia Cardiologica Intensiva e Interventistica, University Hospital of Messina. Electronic address: pasqualecrea@hotmail.it.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Crea
authors.affiliation: Department of Clinical and Experimental Medicine and Unità di Terapia Cardiologica Intensiva e Interventistica, University Hospital of Messina.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Andò
authors.affiliation: Department of Clinical and Experimental Medicine and Unità di Terapia Cardiologica Intensiva e Interventistica, University Hospital of Messina.
authors.forename: Domenico
authors.initials: D
authors.lastname: Zagari
authors.affiliation: Department of Clinical and Experimental Medicine and Unità di Terapia Cardiologica Intensiva e Interventistica, University Hospital of Messina.
authors.forename: Antonio
authors.initials: A
authors.lastname: Giordano
authors.affiliation: Department of Clinical and Experimental Medicine and Unità di Terapia Cardiologica Intensiva e Interventistica, University Hospital of Messina.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Picciolo
authors.affiliation: Department of Clinical and Experimental Medicine and Unità di Terapia Cardiologica Intensiva e Interventistica, University Hospital of Messina.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Oreto
mesh_terms: D002037:Bundle-Branch Block / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control*; D058409:Cardiac Resynchronization Therapy Devices; D017147:Defibrillators, Implantable; D004562:Electrocardiography / Q000379:methods; D006333:Heart Failure / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control
keywords: AV delay; Heart failure; Resynchronization therapy; Right bundle branch block; Ventricular pacing