Output-dependent His bundle pacing: Unexpected His-Purkinje system pathology unmasking.
Ronpichai ChokesuwattanaskulNoppachai SiranartKrit JongnarangsinPublished in: Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc (2024)
The anatomy of the His-Purkinje system has been studied, yet there remains a knowledge gap regarding the impact of His bundle pacing and its electrocardiographic implications. This case report highlights the presence of His-Purkinje system pathology without apparent clues on the surface electrocardiogram (EKG). By observing identical QRS morphology with varying HV intervals resulting from different pacing outputs, we demonstrate the presence of an electrical propagation block within the His bundle.