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The term intraventricular conduction delay or intraventricular conduction disturbances (IVCDs) refers to disturbances in the intraventricular propagation of supraventricular impulses resulting in changes in the QRS complex either in morphology or duration, or both.
The last pair to activate is the distal CS. This pattern is considered normal and is referred to as concentric conduction. This image is from the same patient as the recording above. The ventricular pacing cycle length has been decreased to 400ms. Retrograde atrial activation on the CS catheter is now visualized first on CS channel 3-4.