Absence of right bundle branch block morphology in V1 during left bundle branch pacing. What is the mechanism?

2021 ◽  
Author(s):  
Krishna Kumar Mohanan Nair ◽  
Narayanan Namboodiri ◽  
Ali Shafeeq ◽  
Nitin Kumar Parashar ◽  
Ajitkumar Valaparambil
Keyword(s):  
Right Bundle Branch Block ◽  
Bundle Branch Block

Diagnosis and Ablation of Fascicular Tachycardia

2011 ◽  
Vol 3 (1) ◽  
pp. 67
Author(s):  
Akihiko Nogami ◽  
Keyword(s):  
Ventricular Tachycardia ◽  
Right Bundle Branch Block ◽  
Axis Deviation ◽  
Exit Site ◽  
Rare Form ◽  
Bundle Branch Block ◽  
Diagnosis And Therapy ◽  
Narrow Qrs ◽  
Left Posterior ◽  
Qrs Morphology

Verapamil-sensitive fascicular ventricular tachycardia (VT) is the most common form of idiopathic left VT. According to the QRS morphology and the successful ablation site, left fascicular VT can be classified into three subgroups: left posterior fascicular VT, whose QRS morphology shows right bundle branch block (RBBB) configuration and superior axis (common form); left anterior fascicular VT, whose QRS morphology shows RBBB configuration and right-axis deviation (uncommon form), and upper septal fascicular VT, whose QRS morphology shows narrow QRS configuration and normal or right-axis deviation (rare form). Posterior and anterior fascicular VT can be successfully ablated at the posterior or anterior mid-septum with a diastolic Purkinje potential during VT or at the VT exit site with a fused pre-systolic Purkinje potential. Upper septal fascicular VT can also be ablated at the site with diastolic Purkinje potential at the upper septum. Recognition of the heterogeneity of this VT and its unique characteristics should facilitate appropriate diagnosis and therapy.

Incidence, Clinical Characteristics, and Prognostic Significance of Right Bundle-Branch Block in Acute Myocardial Infarction

Circulation ◽  
1997 ◽  
Vol 96 (4) ◽  
pp. 1139-1144 ◽  
Author(s):  
Antonio Melgarejo-Moreno ◽  
Jose Galcerá-Tomás ◽  
Arcadio García-Alberola ◽  
Mariano Valdés-Chavarri ◽  
Francisco J. Castillo-Soria ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Right Bundle Branch Block ◽  
Clinical Characteristics ◽  
Prognostic Significance ◽  
Bundle Branch Block

scholarly journals Sustained ventricular tachycardia of left, right or both bundle branch block morphology in patients with Arrhythmogenic Cardiomyopathy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Milman ◽  
M Laredo ◽  
R Roudijk ◽  
G Peretto ◽  
A Andorin ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Right Bundle Branch Block ◽  
Left Bundle Branch Block ◽  
Clinical Course ◽  
Left Ventricular ◽  
Funding Source ◽  
Arrhythmogenic Cardiomyopathy ◽  
Icd Implantation ◽  
Bundle Branch Block ◽  
Group 3

Abstract Aims In arrhythmogenic cardiomyopathy (ACM) sustained monomorphic ventricular tachycardia (VT) typically displays left bundle branch block (LBBB) morphology. Sustained VT with right bundle branch block (RBBB) morphology is very rare despite the frequent left ventricular involvement. The present study sought to assess the prevalence of spontaneous sustained LBBB-VT, RBBB-VT or both as well as clinical and genetic differences associated with these VT types. Methods and results Twenty-six centers from 11 European countries provided information on 952 patients with ACM and >1 episode of sustained VT observed during the patients' clinical course. VT was classified as: LBBB-VT; RBBB-VT or LBBB+RBBB-VT. Among 952 patients, 881 (92.5%) had LBBB-VT alone, 71 (7.5%) had RBBB-VT [alone in 42 (4.4%) patients or with LBBB-VT in 29 (3.0%) patients]. Male prevalence was 90.5%, 79.2% and 55.9% in the RBBB-VT, LBBB-VT and LBBB+RBBB-VT groups, respectively (P=0.001). Patients' age at first VT did not differ amongst the 3 VT groups. ICD implantation was more frequent for the RBBB-VT and the LBBB+RBBB groups (≈90% each) vs. 67.9% for the LBBB-VT group (P=0.001). Death incidence (9.5%–17.2%) was not significantly different between the 3 groups (P=0.425). Plakophylin-2 mutations predominated in the LBBB-VT and LBBB-VT+RBBB-VT groups (47.2% and 27.3%, respectively) and Desmoplakin mutations in the RBBB-VT group (36.7%). Conclusion This large European survey demonstrates: 1) Sustained RBBB-VT is documented in 7.5% patients with ACM; 2) Males markedly predominate in the RBBB-VT and LBBB-VT groups but not in the LBBB+RBBB VT group; 3) Distribution of desmosomal mutations appears to be different in the 3 VT groups. Funding Acknowledgement Type of funding source: None

Intraventricular conduction defects in patients with st-segment elevation myocardial infarction – the paradox of right bundle branch block

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Fernandes ◽  
F Montenegro ◽  
M Cabral ◽  
R Carvalho ◽  
L Santos ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Right Bundle Branch Block ◽  
Independent Predictor ◽  
Left Ventricular Ejection ◽  
Bundle Branch Block ◽  
Hospital Outcomes ◽  
St Segment Elevation ◽  
Intraventricular Conduction ◽  
St Segment ◽  
Worse Prognosis

Abstract   Intraventricular conduction defects (IVCD) in patients with acute myocardial infarct (AMI) are predictors of a worse prognosis. When acquired they can be the result of an extensive myocardial damage. Purpose To assess the impact of IVCD, regardless of being previously known or presumed new, on in-hospital outcomes of patients with AMI with ST segment elevation (STEMI) or undetermined location. Methods From a series of patients included in the National Registry of Acute Coronary Syndrome between 10/1/2010 and 9/1/2019, were selected patients with STEMI or undetermined AMI, undergoing coronary angiography. Results 7805 patients were included: 461 (5.9%) presenting left bundle branch block (LBBB), 374 (4.8%) with right bundle branch block (RBBB) and 6970 (89.3%) with no IVCD. Clinical characteristics as well as in-hospital outcomes are described in the table 1. An unexpected worse prognosis in patients with RBBB has motivated a multivariate analysis. RBBB remained an independent predictor of in-hospital mortality (OR 1.91, 95% CI 1.04–3.50, p=0.038), along with female gender (OR 1.73, 95% CI 1.11–2.68, p=0.015), Killip Class>1 (OR 2.26, 95% CI 1.45–3.53, p<0.001), left ventricular ejection fraction <50% (OR 3.93, 95% CI 2.19–7.05, p<0.001) and left anterior descending artery as the culprit lesion (OR 1.85, 95% CI 1.16–2.91, p=0.009). Conclusion In spite of an apparent better clinical profile, in the current large series of unselected STEMI patients, the presence of RBBB is associated with the worst in-hospital outcome. RBBB doubles the risk of death, being an independent predictor of in-hospital mortality. Funding Acknowledgement Type of funding source: None

scholarly journals Assessment of the electrocardiogram in dogs with visceral leishmaniasis

2013 ◽  
Vol 33 (5) ◽  
pp. 643-647 ◽  
Author(s):  
Marlos G. Sousa ◽  
Roberta Carareto ◽  
Jeanna G. Silva ◽  
Juliana Oliveira
Keyword(s):  
Visceral Leishmaniasis ◽  
Left Atrium ◽  
Right Bundle Branch Block ◽  
Small Subset ◽  
Human Beings ◽  
Sinus Arrest ◽  
Bundle Branch Block ◽  
Myocardial Hypoxia ◽  
Premature Beats

As myocarditis and arrhythmias have been shown to occur in both human beings and dogs with leishmaniasis, electrocardiograms of 105 dogs serologically positive for this disease were assessed for rhythm disturbances and changes in ECG waves. A few expressive alterations were seen, including sinus arrest, right bundle branch block, and atrial premature beats in 14.3%, 4.8%, and 4.8% of the studied subjects, respectively. Also, the analysis of ECG waves showed changes suggestive of left atrium and ventricle enlargements, and myocardial hypoxia in some animals. Although cardiac compromise has been previously reported in dogs with leishmaniasis, only a small subset of dogs showed any alteration in the electrocardiogram, which cannot support the occurrence of myocarditis in this investigation.

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