Abstract:
:A 53-year-old woman with sinus node dysfunction underwent dual-chamber pacemaker implantation through a persistent left superior vena cava draining into the coronary sinus, which was detected at the time of implantation. We managed to fix the ventricular lead in the right ventricular (RV) apex by forming a clockwise loop in the right atrium. Inadvertently, the lead was placed in the middle cardiac vein resembling RV apical position under fluoroscopic guidance. The paced QRS complex showed a pattern of tall R in V(1) through V(3), RS in V(4) through V(5), and QS in V(6). The pacing lead was carefully manipulated back into the RV apex, with the paced QRS complex showing a pattern of right bundle branch block, rR' in V(1) through V(2), and QS in V(3) through V(6). Careful attention to the surface electrocardiogram helps in distinguishing the pacing site even in those patients showing a pseudo-right bundle branch block pattern with RV apical pacing.
journal_name
J Electrocardioljournal_title
Journal of electrocardiologyauthors
Chen TE,Wang CC,Satish OS,Wu Ddoi
10.1016/j.jelectrocard.2007.05.016subject
Has Abstractpub_date
2007-11-01 00:00:00pages
531-3issue
6eissn
0022-0736issn
1532-8430pii
S0022-0736(07)00572-9journal_volume
40pub_type
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