Abstract
ular myocardium. They noted that intracavitary right ventricular potentials from these areas resembled left ventricular recordings. Direct stimulation of these fibers may preferentially excite the left ventricle. Our data could support the hypothesis that the posterior stimulation sites in the right ventricle preferentially excite such specialized myocardial bands. However, pacing patterns from the epicardially located coronary sinus/middle cardiac vein area are similar to the one described herein.& The RBBB QRS pattern can also be explained by a posteroanterior QRS vector in the horizontal plane. In conclusion, the occurrence of a RBBB QRS morphology during right ventricular pacing does not exclude a right ventricular endocardial electrode location and verification of lead position remains desirable. Since this report was written, two more patients with RBBB paced QRS complexes during posterior right ventricular endocardial pacing have been observed.
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