A curious change in QRS morphology during epicardial pacing
Udbhav Kharad, Ahmed Almarzuqi, George J. Klein · 2026
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Description
Udbhav Kharad and colleagues puzzled over a shifting heart tracing in a paced patient after heart surgery. Published in 2026, the case covers a 66-year-old man with a junctional rhythm plus a pre-existing right bundle branch block in acute care. Short-term pacing wires sat on his right atrium and right ventricle, pacing in DDD mode at 89 beats per minute.
Monitor strips showed abrupt, brief flips from a fairly narrow QRS to a wide-complex rhythm and back. The authors trace the narrow beats to fusion: the paced right-side impulse beat native right activation while matching left-side firing through the left bundle. That fusion beat ran slimmer than both the native block beat and a fully paced beat. Readers get a worked example of how pacing and native conduction can blend on the monitor.
Catalog record
| CREATOR | Udbhav Kharad, Ahmed Almarzuqi, George J. Klein |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 13 KB |
| VERSION | 1.0 |
| LICENSE | CC BY 4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |