Output-dependent His bundle pacing: Unexpected His-Purkinje system pathology unmasking
Ronpichai Chokesuwattanaskul1,2, Noppachai Siranart1, Krit Jongnarangsin3
1Department of Medicine, Faculty of Medicine, Cardiac Center, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Thai Red Cross Society, Bangkok, Thailand.
Abstract:
The anatomy of the His-Purkinje system has been studied, yet there remains a knowledge gap regarding the impact of His bundle pacing and its electrocardiographic implications. This case report highlights the presence of His-Purkinje system pathology without apparent clues on the surface electrocardiogram (EKG). By observing identical QRS morphology with varying HV intervals resulting from different pacing outputs, we demonstrate the presence of an electrical propagation block within the His bundle.
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