Abstract
Right bundle branch block (RBBB) configuration is an unexpected finding during right ventricular (RV) pacing that raises the suspicion of inadvertent left ventricular lead positioning. The aim of this study was to evaluate the prevalence of paced RBBB pattern in relation to RV lead location. This is a secondary analysis of a prospective, multicenter study, which randomized implantable cardioverter defibrillator recipients to an apical versus midseptal defibrillator lead positioning. A 12-lead electrocardiogram was recorded during intrinsic rhythm and RV pacing. Paced RBBB-like pattern was defined as positive (>0.05 mV) net amplitude of QRS complex in leads V1 and/or V2. In total, 226 patients (65.6 ± 12.0 years, 20.8% women, 53.1% apical site) were included in the study. The prevalence of paced RBBB pattern in the total population was 15.5%. A significantly lower percentage of patients in the midseptal group demonstrated RBBB-type configuration during RV pacing compared with the apical group (1.9% vs 27.5%, p <0.001). Baseline RBBB, prolonged QRS duration during intrinsic rhythm, and reduced ejection fraction were not associated with increased likelihood of paced RBBB. In the subgroup of patients with RBBB type during pacing, 9...Continue Reading
References
Apr 1, 1985·Chest·H O KleinE Kaplinsky
May 1, 1969·British Heart Journal·S S BaroldP Samet
Jul 1, 1967·American Heart Journal·M M MowerB Tabatznik
Oct 15, 1995·The American Journal of Cardiology·J A Coman, R G Trohman
Jun 5, 2003·Circulation·Michael O SweeneyUNKNOWN MOde Selection Trial Investigators
Apr 4, 2006·Journal of Electrocardiology·Eric James Hemminger, John Michael Criley
Oct 28, 2006·Angiology·Ertan OkmenTanju Ulufer
Oct 5, 2010·Journal of Electrocardiology·Marwan RefaatE Kevin Heist
Jul 30, 2011·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Avi ShimonyGuy Amit
Sep 29, 2011·Cardiology Journal·S Serge Barold, Bengt Herweg
Jan 21, 2014·International Journal of Cardiology·Mohammed AlmehairiAdrian Baranchuk
May 20, 2014·International Journal of Cardiology·Christof KolbUNKNOWN SPICE-investigators
Jan 13, 2015·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·George AndrikopoulosUNKNOWN SPICE Study Investigators
Jun 30, 2015·The Canadian Journal of Cardiology·Mohammed AlmehairiChristopher S Simpson
Citations
Jun 28, 2016·Expert Review of Medical Devices·S Serge Barold, Michael C Giudici
Oct 16, 2018·The Journal of International Medical Research·Li LaiRong Luo
Nov 16, 2016·Herzschrittmachertherapie & Elektrophysiologie·Harilaos BogossianMarkus Zarse
Sep 6, 2020·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Dylan F MarchlinskiFrancis E Marchlinski