Abnormal Electrocardiogram after a Pacemaker

Author:

Agarwal Rakesh1

Affiliation:

1. Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia

Abstract

After implanting a right ventricular pacemaker lead, it is common to have a left bundle branch block pattern on the electrocardiogram (ECG) in paced QRS complexes. We report a case of an elderly female who demonstrated a right bundle branch block (RBBB) pattern in the right-sided precordial leads V1-V2 after undergoing a pacemaker implantation. This was a cause of worry as it usually indicates a complication of the surgery and may require lead revision. However, we demonstrated that such a pattern could be normally seen. In this article, we review the features that can help in differentiating a RBBB pattern associated with pacemaker implant-associated complications from an uncomplicated one. An intelligent analysis of the ECG can help in differentiating the complicated from benign forms of RBBB in such cases.

Publisher

Medknow

Reference10 articles.

1. Electrocardiographic analysis of Paced rhythms;Pugazhendhi;Card Electrophysiol Clin,2014

2. An electrocardiographic algorithm for determining the location of pacemaker electrode in patients with right bundle branch block configuration during permanent ventricular pacing;Okmen;Angiology,2006

3. Transarterial permanent pacing of the left ventricle;Mazzetti;Pacing Clin Electrophysiol,1990

4. Right bundle branch block pattern during right ventricular permanent pacing: Is it safe or not?;Erdogan;Indian Pacing Electrophysiol J,2007

5. Effect of pacemaker site on cardiac output and ventricular activation in dogs with complete heart block;Lister;Am J Cardiol,1964

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