Department of Medicine, Baylor College of Medicine, Houston, Texas.
Department of Pediatrics, Division of Pediatric Cardiology, Baylor College of Medicine, Houston, Texas.
Tex Heart Inst J. 2024 Apr 2;51(1). doi: 10.14503/THIJ-23-8268.
This report discusses a case of transient 2:1 atrioventricular block with conduction system pacing 4 hours after leadless right ventricular pacemaker implantation in a 19-year-old patient with a history of cardioinhibitory syncope and asystole cardiac arrest but without preexisting atrioventricular block. The atrioventricular block was resolved spontaneously. Pacing morphology was suggestive of right bundle branch pacing. Neither 2:1 atrioventricular block nor conduction system pacing has previously been a reported outcome of right ventricular leadless pacemaker implantation. The report demonstrates that conduction system pacing with leadless devices is achievable. Further study of techniques, limitations, and complications related to intentional right ventricular leadless conduction system pacing is warranted.
本报告讨论了一例 19 岁患者在无导线右心室起搏器植入后 4 小时出现一过性 2:1 房室传导阻滞并伴有传导系统起搏的病例。该患者有心搏停止的心脏停搏和心动过缓晕厥病史，但无先前存在的房室传导阻滞。房室传导阻滞自行缓解。起搏形态提示右束支起搏。无导线右心室起搏器植入后出现 2:1 房室传导阻滞和传导系统起搏均未见报道。该报告表明，无导线器械可实现传导系统起搏。需要进一步研究与右心室无导线传导系统起搏相关的技术、局限性和并发症。
