Abstract
During para-Hisian pacing, widening of the paced QRS complex usually indicates loss of His bundle capture. We describe a patient without any accessory pathways in whom widening of the paced QRS complex occurred due to loss of left bundle branch capture during para-Hisian pacing. After initial widening of the QRS complex, further widening was observed due to loss of His bundle capture. With the initial QRS widening, the stimulus-atrial interval and retrograde atrial activation sequence were almost unchanged, so the findings mimicked retrograde conduction over an accessory pathway. This may be a pitfall of the para-Hisian pacing technique.
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References
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Adachi, M., Igawa, O., Miake, J. et al. QRS complex widening due to loss of left bundle branch capture: pitfall of para-Hisian pacing. J Interv Card Electrophysiol 25, 213–216 (2009). https://doi.org/10.1007/s10840-008-9345-8
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DOI: https://doi.org/10.1007/s10840-008-9345-8