Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2024; 12(22): 5276-5282
Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.5276
Selective his bundle pacing eliminates crochetage sign: A case report
Yan-Guang Mu, Ke-Sen Liu
Yan-Guang Mu, Ke-Sen Liu, Department of Arrhythmia, Weifang People's Hospital, Weifang 261000, Shandong Province, China
Author contributions: Mu YG and Liu KS contributed to the conceptualization, manuscript writing and editing, and data collection; all authors have read and approved the final manuscript.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ke-Sen Liu, MD, Attending Doctor, Department of Arrhythmia, Weifang People's Hospital, No. 151 Guang Wen Street, Weifang 261000, Shandong Province, China. liukesen@126.com
Received: May 9, 2024
Revised: June 7, 2024
Accepted: June 18, 2024
Published online: August 6, 2024
Processing time: 53 Days and 21.8 Hours
Abstract
BACKGROUND

Crochetage sign is a specific electrocardiographic manifestation of ostium secundum atrial septal defects (ASDs), which is associated with the severity of the left-to-right shunt. Herein, we reported a case of selective his bundle pacing (S-HBP) that eliminated crochetage sign in a patient with ostium secundum ASD.

CASE SUMMARY

A 77-year-old man was admitted with a 2-year history of chest tightness and shortness of breath. Transthoracic echocardiography revealed an ostium secundum ASD. Twelve-lead electrocardiogram revealed atrial fibrillation with a prolonged relative risk interval, incomplete right bundle branch block, and crochetage sign. The patient was diagnosed with an ostium secundum ASD, atrial fibrillation with a second-degree atrioventricular block, and heart failure. The patient was treated with selective his bundle pacemaker implantation. After the procedure, crochetage sign disappeared during his bundle pacing on the electrocardiogram.

CONCLUSION

S-HBP eliminated crochetage sign on electrocardiogram. Crochetage sign may be a manifestation of a conduction system disorder.

Keywords: Crochetage sign, Atrial septal defect, Pacemaker, Selective his bundle pacing, Case report

Core Tip: Crochetage sign is a characteristic electrocardiographic manifestation seen in patients with ostium secundum atrial septal defects. We reported the case of a patient with secundum atrial septal defect, atrial fibrillation, and second-degree atrioventricular block who received selective his bundle pacing (S-HBP) treatment. Subsequently, crochetage sign was eliminated by S-HBP. Crochetage sign may indicate a conduction system disease.