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Open Access 07-04-2022 | Rhythm Puzzle – Question

Cardiac resynchronisation therapy in optima forma

Auteurs: S. A. J. Timmer, T. Germans

Gepubliceerd in: Netherlands Heart Journal | Uitgave 5/2022

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A 60-year-old male with heart failure and severely reduced left ventricular function was scheduled for elective implantation of a cardiac resynchronisation therapy defibrillator device. Coronary artery angiography revealed no significant coronary artery disease. He remained symptomatic despite guideline-directed optimal medical therapy. The ambulatory electrocardiogram (ECG) showed sinus rhythm with a slightly prolonged PR interval, ventricular ectopic beats and complete left bundle branch block (LBBB) with QRS duration ~150 ms and mid-QRS notching in > 2 leads, consistent with the Strauss criteria for LBBB (Fig. 1; [1]). The device implantation was successful, and there were no procedural complications. A postoperative ECG was obtained on the cardiology ward shortly after the procedure (Fig. 2).
What type of pacing can be seen, and what other distinctive pathology is revealed?

Answer

You will find the answer elsewhere in this issue.

Conflict of interest

S.A.J. Timmer is consultant for Medtronic. T. Germans declares that he has no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.
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Netherlands Heart Journal

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Literatuur
1.
go back to reference Strauss DG, Selvester RH, Wagner GS. Defining left bundle branch block in the era of cardiac resynchronization therapy. Am J Cardiol. 2011;107:927–34.CrossRef Strauss DG, Selvester RH, Wagner GS. Defining left bundle branch block in the era of cardiac resynchronization therapy. Am J Cardiol. 2011;107:927–34.CrossRef
Metagegevens
Titel
Cardiac resynchronisation therapy in optima forma
Auteurs
S. A. J. Timmer
T. Germans
Publicatiedatum
07-04-2022
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 5/2022
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-022-01682-y

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