Right bundle branch block pacing pattern (complicated and uncomplicated) on ECG with right ventricular pacing in a single patient – A case report

The present case report describes a patient with ostium secundum ASD with symptomatic high grade AV block, who underwent pacemaker implantation and whose post procedure surface ECG was suggestive of malpositioned left ventricular pacing after temporary as well as permanent pace maker implantation. Diagnostic clues on surface ECG for differentiating right bundle branch block pacing pattern with left ventricular as well as right ventricular pacing are thoroughly revisited and discussed in this article. To the best of our knowledge this is probably the first case report from India whereby right bundle branch block pacing pattern (complicated and uncomplicated) with right ventricular pacing in a single patient has been observed.