Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.5276
Revised: June 7, 2024
Accepted: June 18, 2024
Published online: August 6, 2024
Processing time: 53 Days and 21.8 Hours
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.
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.
S-HBP eliminated crochetage sign on electrocardiogram. Crochetage sign may be a manifestation of a conduction system disorder.
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.