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An 86-year-old man was hospitalised for congestive heart failure. He had severe aortic stenosis, had previously undergone implantation of a single-chamber pacemaker and was in permanent atrial fibrillation. ECG at admission showed paced ventricular stimulation and a somewhat atypical left bundle branch block (LBBB) aspect, as well as atrial fibrillation (figure 1A). The night following admission, he suffered an episode of severe paroxysmal nocturnal dyspnoea (O2 desaturation of 75%). …
Contributors All the authors made substantial contributions to every aspect of this letter.
Competing interests None.
Patient consent Obtained.
Provenance and peer review Not commissioned; internally peer reviewed.
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