The pathologic correlates of the electrocardiogram: complete left bundle branch block.

نویسندگان

  • C J Havelda
  • G S Sohi
  • N C Flowers
  • L G Horan
چکیده

To assess whether gross pathologic differences exist between hearts with left bundle branch block (LBBB) and left-axis deviation (LAXD) and those with LBBB and a normal frontal plane axis, we examined 70 hearts with LBBB in a series of 1410 sequential dissections (5%). Thirty-two hearts had LAXD and 34 had normal axes on the correlative ECG. Left ventricular enlargement occurred frequently (93%). No significant differences were found in age distribution, left ventricular weight, coronary anatomy or infarct location. Quantitative analysis revealed larger inferoposterolateral and apical infarcts in hearts with LBBB and LAXD (p less than 0.01). The accuracy of various electrocardiographic signs of left ventricular enlargement and myocardial infarction in the presence of LBBB was assessed. Voltage criteria and QRS duration poorly define anatomic chamber enlargement. Anterior infarction is suggested by a q or pathological Q wave in lead I, a q wave in leads I, V5 and V6, or notched S waves in V3 or V4. Pathologic q waves or ST shifts in the inferior leads have high diagnostic specificity but low sensitivity for inferior infarction.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Left bundle branch block and left ventricular hypertrophy: electrocardiographic-pathologic correlations.

A clinical-pathologic study was made of 50 patients with complete left bundle branch block who had postmortem examinations performed at three Salt Lake City hospitals. Forty (80 percent) were found to have left ventricular hypertrophy as determined from measured left ventricular wall thickow but only 14 had electrocardiographic evidence of this while two of the ten patients without left ventric...

متن کامل

Vector electrocardiographic alterations after percutaneous septal ablation in obstructive hypertrophic cardiomyopathy. Possible anatomic causes.

OBJECTIVE Analyze the dromotropic disturbances (vector-electrocardiographic), and the possible anatomic causes, provoked by selective alcohol injection in the septal branch, for percutaneous treatment, of obstructive hypertrophic cardiomyopathy. METHODS Ten patients with a mean age of 52.7 years underwent percutaneous septal ablation (PTSA) from october 1998; all in functional class III/IV). ...

متن کامل

Rate dependent left bundle branch block with gradual transition between normal intraventricular conduction and complete left bundle branch block. A case report.

A case of 70-year-old woman with ischemic heart disease is presented. The electrocardiogram showed atrial fibrillation and a tachycardia-dependent, left bundle branch block. A number of intermediate QRS patterns from normal intraventricular conduction to complete left bundle branch block were seen, and the transition was gradual. Increasing grades of aberrance were seen following a shorter prec...

متن کامل

Observations on the electrocardiogram and ventricular gradient in complete left bundle branch block.

Electrocardiograms from 109 patients with left bundle branch block were divided into four major groups depending on differences in standard and unipolar precordial leads. These records were then studied to find if one can draw any conclusions relative to ventricular hypertrophy or myocardial infarction in the presence of left branch block. In addition, the ventricular gradient was estimated in ...

متن کامل

Perioperative risk of complete heart block in patients with bifascicular block and prolonged PR interval.

Because there is a paucity of information on the perioperative risk of developing complete heart block among patients with bifascicular block (either right bundle branch block and left anterior hemiblock or left bundle branch block) and a long PR interval on the surface electrocardiogram, we undertook an analysis of 76 such patients. Twenty-three patients had right bundle branch block and left ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Circulation

دوره 65 3  شماره 

صفحات  -

تاریخ انتشار 1982