%0 Journal Article %A Chee Loong Chow %A Barveen Abu Baker %A Uwais Mohamed %T Pacing: a new look. Don’t be deceived %D 2018 %R 10.1136/heartjnl-2018-313392 %J Heart %P 1491-1528 %V 104 %N 18 %X 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. %U https://heart.bmj.com/content/heartjnl/104/18/1491.full.pdf