Right Ventricular Septal Pacing: In Lieu of Biventricular Pacing for Cardiac Resynchronization in a Patient With Right Bundle Branch Block?
Keywords:heart failure, cardiac resynchronization therapy, right bundle branch block
AbstractA 71-year-old male with ischemic cardiomyopathy, severe systolic left ventricular dysfunction and symptomatic heart failure was not considered a good candidate for implantation of a biventricular pacing system to effect cardiac resynchronization due to underlying right bundle branch block (RBBB). He received instead a dual-chamber implantable cardioverter defibrillation with the ventricular lead placed at an alternate site position at the high right ventricular septum. This resulted in significant narrowing of the QRS duration (resynchronization) with a good clinical response over short-term. The case illustrates a possible alternative approach to biventricular pacing for cardiac resynchronization in patients with RBBB.
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