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    An unusual pacemaker malposition and delayed diagnosis
    (Dicle Üniversitesi Tıp Fakültesi, 2015) Alan, Bircan; Dusak, Abdurrahim; Çetinçakmak, Mehmet G.; Alan, Sait
    Transvenous right ventricular pacing usually shows a left bundle branch block (LBBB) pattern. When right bundle branch block (RBBB) pattern appears after the insertion of an electrode, perforation or malposition of the pacing lead usually occurs. However, when the pacing lead that is inserted into the coronary sinus or right ventricle extends to right ventricle septum, RBBB pattern may appear. Echocardiography, due to inadequate echo images or reflections, may result in early clinical misdiagnosis since it cannot be evaluated well. Another reason for the errors in diagnosis is that cardiologists generally relegate telegraphy evaluations to a second plan. Here, we present a case of pacemaker malposition, which was diagnosed using X-ray radiography after multiple failed evaluations with echocardiography.