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Cardiac resynchronization therapy resulting from atrial pacing: An unusual case of intraventricular conduction delay
Author(s) -
Thurber Clinton J.,
Suarez Keith,
Banchs Javier E.
Publication year - 2018
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13437
Subject(s) - medicine , cardiac resynchronization therapy , cardiology , coronary sinus , qrs complex , ventricular pacing , heart failure , bradycardia , cardiac pacing , sinus bradycardia , atrioventricular block , heart rate , ejection fraction , blood pressure
Cardiac resynchronization therapy device implantation is complicated by a significant rate of failure to place a left ventricular lead via the coronary sinus. The present case describes one such failure ironically leading to resynchronization. The patient's QRS narrowing subsequent to postimplant atrial pacing alone suggests that bradycardia‐dependent phase 4 block was the indirect but exclusive cause of the patient's intraventricular conduction delay. Thus, phase 4 block should be considered when atrial pacing at a faster rate resolves a wide QRS interval.