Mu Yan-Guang, Liu Ke-Sen
Department of Arrhythmia, Weifang People's Hospital, Weifang 261000, Shandong Province, China.
World J Clin Cases. 2024 Aug 6;12(22):5276-5282. doi: 10.12998/wjcc.v12.i22.5276.
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.
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.
S-HBP eliminated crochetage sign on electrocardiogram. Crochetage sign may be a manifestation of a conduction system disorder.
“钩编征”是继发孔型房间隔缺损（ASD）的一种特异性心电图表现，与左向右分流的严重程度相关。在此，我们报告了一例通过选择性希氏束起搏（S-HBP）消除继发孔型ASD患者“钩编征”的病例。
一名77岁男性因胸闷、气短2年入院。经胸超声心动图显示继发孔型ASD。十二导联心电图显示房颤伴相对危险间期延长、不完全性右束支传导阻滞及“钩编征”。该患者被诊断为继发孔型ASD、房颤伴二度房室传导阻滞及心力衰竭。患者接受了选择性希氏束起搏器植入治疗。术后，心电图显示希氏束起搏时“钩编征”消失。
S-HBP消除了心电图上的“钩编征”。“钩编征”可能是传导系统疾病的一种表现。
