Barold S S, Banner R
Pacing Clin Electrophysiol. 1978 Jan;1(1):31-4. doi: 10.1111/j.1540-8159.1978.tb03438.x.
This report documents the unusual occurrence of a left bundle branch block pattern of ventricular depolarization during permanent pacing from the middle cardiac vein. All previous reports of ventricular pacing from the middle cardiac vein have described a right bundle branch block pattern of ventricular activation (dominant R-waves in the right precordial leads), except in one case where both right and left bundle branch block patterns occurred at separate times. A high posterior infarct allowed early activation of the right ventricle from the middle cardiac vein. Undue reliance on the electrocardiogram may detract from the diagnosis of electrode malposition.
本报告记录了从中心脏静脉进行永久起搏时心室去极化出现左束支传导阻滞模式这一不寻常情况。之前所有关于从中心脏静脉进行心室起搏的报告均描述心室激动为右束支传导阻滞模式（右胸前导联出现显性R波），仅有1例报告在不同时间分别出现了右束支传导阻滞模式和左束支传导阻滞模式。高位后壁梗死使得右心室能从中心脏静脉较早激动。过度依赖心电图可能会影响电极位置不当的诊断。
