A case report of a rare and distinctive pacing pattern during left bundle branch pacing in a child with third-degree atrioventricular block following ventricular septal defect repair - Takeaways - MDSpire

A case report of a rare and distinctive pacing pattern during left bundle branch pacing in a child with third-degree atrioventricular block following ventricular septal defect repair

  • By

  • Yue Bao

  • Wenwen Chen

  • Qingqun Zhang

  • Hongwei Han

  • June 15, 2026

  • 0 min

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  • 1

    A 3-year-old girl developed third-degree atrioventricular block and right bundle branch block after ventricular septal defect repair.

  • 2

    Left bundle branch pacing (LBBP) was performed, but initial pacing produced an unexpected right bundle branch block pattern on ECG.

  • 3

    This phenomenon is rare and may indicate proximal conduction system block due to surgical scarring from the VSD repair.

  • 4

    The pacing lead initially contacted the right ventricular septum, leading to atypical RBBB-like pacing morphology.

  • 5

    Post-procedure, the patient's pacemaker parameters were satisfactory, and echocardiography showed normal cardiac function.

Original Source(s)

A case report of a rare and distinctive pacing pattern during left bundle branch pacing in a child with third-degree atrioventricular block following ventricular septal defect repair

  • by Yue Bao, Wenwen Chen, Qingqun Zhang, Hongwei Han

  • June 15, 2026

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