Selective his bundle pacing eliminates crochetage sign: A case report
1Department of Arrhythmia, Weifang People's Hospital, Weifang 261000, Shandong Province, China.
Insights
Selective His bundle pacing (S-HBP) effectively eliminated the crochetage sign in a patient with an ostium secundum atrial septal defect (ASD). This finding suggests the crochetage sign may indicate a conduction system disorder.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Diagnostics
Background:
- The crochetage sign on an electrocardiogram (ECG) is a specific indicator of ostium secundum atrial septal defects (ASDs).
- Its presence is linked to the severity of the left-to-right shunt in ASD patients.
Background:
Crochetage sign is a specific electrocardiographic manifestation of ostium secundum atrial septal defects (ASDs), which is associated with the severity of the left-to-right shunt. Herein, we reported a case of selective his bundle pacing (S-HBP) that eliminated crochetage sign in a patient with ostium secundum ASD.
Case Summary:
A 77-year-old man was admitted with a 2-year history of chest tightness and shortness of breath. Transthoracic echocardiography revealed an ostium secundum ASD. Twelve-lead electrocardiogram revealed atrial fibrillation with a prolonged relative risk interval, incomplete right bundle branch block, and crochetage sign. The patient was diagnosed with an ostium secundum ASD, atrial fibrillation with a second-degree atrioventricular block, and heart failure. The patient was treated with selective his bundle pacemaker implantation. After the procedure, crochetage sign disappeared during his bundle pacing on the electrocardiogram.
Conclusion:
S-HBP eliminated crochetage sign on electrocardiogram. Crochetage sign may be a manifestation of a conduction system disorder.
