A Case Report: Electrotonic Modulation-Related T-Wave Over-Sensing After Left Bundle Branch Pacing
Linlin Li1, Manxin Lin1, Jincun Guo1
1Division of Cardiology, Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, Fujian, China.
None:
A 66-year-old male patient diagnosed with dilated cardiomyopathy, heart failure with reduced EF (32%), and complete left bundle branch block (CLBBB) received cardiac resynchronization therapy (CRT)-D implantation. Left bundle branch pacing (LBBP) was successfully performed, but during the follow-up 6 weeks later, the electrocardiogram (ECG) showed a sinus rhythm tracked by ventricular pacing with a ratio of approximately 2:1 due to T-wave over-sensing, which might be caused by the changes in T-wave morphology due to electrotonic modulation and hyperkalemia or by the lower sensitivity threshold set by the auto sensing algorithm of the ICD. Shortening post-ventricular atrial refractory period (PVARP) restored the ventricular pacing tracking of the atrium, and the T-wave changes improved as time went by.
Related Concept Videos
Electrocardiogram
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
Cardiac Action Potential
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
Pulse rhythm
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Electrophysiology of Normal Cardiac Rhythm
Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...


