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An electrocardiogram on the day after implantation of a dual-chamber pacemaker revealed 2 closely coupled pacing spikes at 100-ms intervals, with the latter being on the trailing edge of the paced QRS complex. Differential diagnoses of such closely coupled pacing pulses include atrial lead displacement, lead reversal on the pulse generator, ventricular premature complex in the post-atrial ventricular blanking period, and backup pacing pulse following a loss of capture. Critical analysis of the pacemaker timing intervals led to the mechanism and cause of the problem.
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http://dx.doi.org/10.1016/j.hrthm.2024.07.013 | DOI Listing |
Turk Kardiyol Dern Ars
September 2025
Department of Cardiology, Necmettin Erbakan University, School of Medicine, Konya, Turkiye.
Cardiac resynchronization therapy (CRT) improves outcomes in heart failure, but prior interventions like percutaneous mitral annuloplasty may hinder lead placement. We present a 70-year-old male with ischemic cardiomyopathy and severe functional mitral regurgitation who previously received a Carillon device. Due to coronary sinus inaccessibility, left bundle branch area pacing optimized cardiac resynchronization therapy (LOT-CRT) was performed.
View Article and Find Full Text PDFEur J Heart Fail
September 2025
Cardiology Department, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Aims: There is a lack of data from randomized clinical trials comparing treatment outcomes between conduction system pacing (CSP) modalities and biventricular pacing (BVP) in symptomatic patients with refractory atrial fibrillation (AF) scheduled for atrioventricular node ablation (AVNA). The CONDUCT-AF investigates whether CSP is non-inferior to BVP in improving left ventricular ejection fraction (LVEF) and clinical outcomes in heart failure (HF) patients with symptomatic AF undergoing AVNA.
Methods: This study is an investigator-initiated, prospective, randomized, multicentre clinical trial conducted across 10 European centres, enrolling 82 patients with symptomatic AF, HF with reduced LVEF, and narrow QRS.
Can J Cardiol
September 2025
Department of Cardiology, Ningbo No.2 Hospital, Ningbo, Zhejiang, China.
Background: During the electrode screwing process in left bundle branch pacing (LBBP), the significance of the S wave in lead V6 remains elusive. Our study analyzes the change of the S wave in lead V6 under different patterns of capture and explores its mechanisms.
Methods: This study included 243 cases with criterion of selective LBBP (SLBBP), we performed continuous pacing technique and classified the electrophysiological characteristics observed during the screwing process into four patterns: left ventricular septal pacing (LVSP), non-selective LBBP (NSLBBP) in low output and in the lower output, selective LBBP.
IEEE J Biomed Health Inform
September 2025
Identifying the onset of the QRS complex is an important step for localizing the site of origin (SOO) of premature ventricular complexes (PVCs) and the exit site of Ventricular Tachycardia (VT). However, identifying the QRS onset is challenging due to signal noise, baseline wander, motion artifact, and muscle artifact. Furthermore, in VT, QRS onset detection is especially difficult due to the overlap with repolarization from the prior beat.
View Article and Find Full Text PDFHeartRhythm Case Rep
August 2025
Cardiac Pacing Unit, Department of Cardiology, University Hospital of Geneva, Geneva, Switzerland.