LEONARD I. GOLDSTEIN, M.D.
To the the editor: The article by Rubin, Arbeit, and Gross (Ann Intern Med 71:603-615, 1969) provides valuable information in the electrocardiographic recognition of pacemaker function and failure. Another valuable bedside clue to the diagnosis of proper pacemaker function is the recognition of reversed splitting of the second heart sound. Haber and Leatham (1) have demonstrated that abnormal splitting of the second heart sound occurs in patients with right ventricular pacemakers. The pacemaker produces a functional left bundle branch block that accounts for a delay in the spread of conduction to the left ventricle and therefore produces a delay in
GOLDSTEIN LI. Pacemaker Failure and ECG. Ann Intern Med. ;72:440–441. doi: 10.7326/0003-4819-72-3-440
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Published: Ann Intern Med. 1970;72(3):440-441.
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