TY - JOUR T1 - Pacing: a new look. Don’t be deceived JF - Heart JO - Heart SP - 1491 LP - 1528 DO - 10.1136/heartjnl-2018-313392 VL - 104 IS - 18 AU - Chee Loong Chow AU - Barveen Abu Baker AU - Uwais Mohamed Y1 - 2018/09/01 UR - http://heart.bmj.com/content/104/18/1491.abstract N2 - Clinical introduction A 78-year-old man presents following a syncopal episode in the setting of intermittent sinus bradycardia and left bundle branch block (LBBB). With symptoms likely due to documented intermittent sinus node dysfunction, and finding of a diseased left bundle, a pacemaker was inserted (online supplementary figure 1 shows the electrode position in a PA fluroscopy view). His baseline ECG is shown in figure 1A, with a QRS width of 160 ms, and his echocardiogram revealed a left ventricular ejection fraction of 45%. His ECG day 1 postdevice insertion is shown in figure 1B. His device check confirmed excellent function. His QRS width on ECG postdevice insertion is now normalised to 80 ms.Supplementary file 1[SP1.jpg]Question What type of device therapy has this patient received?Biventricular pacing.Right ventricular outflow septal pacing.His bundle pacing.Right ventricular apical pacing.Question Figure 1 (A) Baseline ECG and (B) day 1 postpacemaker implantation. ER -