Journal of Electrocardiology
Volume 36, Issue 1 , Pages 67-71, January 2003

Safe right bundle branch block pattern during permanent right ventricular pacing☆

  • Yung-Nien Yang, MD

      Affiliations

    • Division of Cardiology, Department of Internal Medicine, Armed Forces Sung-Shan Hospital
    • ,
  • Wei-Hsian Yin, MD

      Affiliations

    • Division of Cardiology
    • ,
  • Mason Shing Young, MD

      Affiliations

    • Department of Internal Medicine, Cheng-Hsin General Hospital, Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Abstract 

It is known that an electrocardiogram (ECG) after transvenous right ventricular (RV) pacing should yield left bundle branch block (LBBB) QRS patterns. When right bundle branch block (RBBB) pacing morphology appears in a patient with a permanent or temporary transvenous RV pacemaker, myocardial perforation or malposition of the pacing lead must be ruled out, even though the patient may be asymptomatic. We report a case of a 77-year-old man who underwent permanent transvenous VDD pacemaker implantation for symptomatic heart block. The postoperative ECG revealed a RBBB pacing configuration, but his chest X-ray and echocardiographic studies confirmed uncomplicated RV pacing. We review and discuss the literature concerning the differential diagnosis of such a safe RBBB ECG pattern.

Keywords:  Ventricular pacing, right bundle branch block, pacing lead

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☆ Reprint requests: Wei-Hsian Yin, MD, Division of Cardiology, Department of Internal Medicine, Cheng-Hsin General Hospital, 45 Cheng-Hsin St, Pei-Tou, Taipei, Taiwan,R.O.C.; e-mail: yin.wh@msa.hinet.net.

PII: S0022-0736(02)30453-9

doi:10.1054/jelc.2003.50002

Journal of Electrocardiology
Volume 36, Issue 1 , Pages 67-71, January 2003

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