We describe a 66-year-old woman who had an alternating bundle branch block consisting of coexisting occurrence of right bundle branch block (RBBB) and left bundle branch block (LBBB) combined with Mobitz type II atrioventricular block (AVB). A prolonged PQ interval was associated with the RBBB pattern whereas it was not apparent in the LBBB pattern. Electrophysiologic study revealed that the LB...

The clinical usefulness of QRST isointegral maps (IQRST map) for detecting myocardial infarction that was complicated by intraventricular conduction disturbances was evaluated in patients with right bundle branch block (group RBBB, 64 patients) and left bundle branch block (group LBBB, 40 patients) by comparison with the normal mean IQRST map derived from 50 normal subjects. Myocardial infarcti...

Introduction: We aimed to investigate the effect of right bundle branch block (RBBB) on perfusion and functional parameters in dipyridamole stress/rest Tc99m-MIBI gated myocardial perfusion SPECT (GSPECT) which may be helpful in interpretation of myocardial perfusion imaging. Methods: We studied 73 patients with low pre-test likelihood of coronary artery disease in two groups: 38 patients with ...

Electrophysiological studies (His bundle recordings and atrial stimulation) were performed in nine patients who manifested periods of both right and left bundle branch block (RBBB and LBBB). In seven of the patients, alternating bundle branch block appeared to reflect intermittent or chronic bundle branch block superimposed on incomplete (but electrocardiographically complete) block of the cont...

BACKGROUND Despite extensive data examining perioperative risk in patients with coronary artery disease, little attention has been devoted to the implications of conduction system abnormalities. OBJECTIVE To define the clinical significance of bundle-branch block (BBB) as a perioperative risk factor. METHODS Retrospective, cohort-controlled study of all noncardiac, nonophthalmologic, adult ...

The right bundle branch is a long, thin, and discrete structure composed of high-velocity conduction Purkinje fibres. It is located in the right side of the interventricular septum and occupies a subendocardial position in its superior and inferior thirds and deeper in the middle third. There are no ramifications in most of its course, but it starts to branch as it reaches the base of the anter...

BACKGROUND Left bundle branch block (LBBB) and right bundle branch block (RBBB) not only mask electrocardiogram (ECG) changes that reflect diseases but also indicate important underlying pathology. The timely detection of LBBB and RBBB is critical in the treatment of cardiac diseases. Inter-patient heartbeat classification is based on independent training and testing sets to construct and evalu...

A 76-year-old female, with medical history significant for systolic congestive heart failure, who presented to the emergency department with lethargy and abdominal pain with diarrhea for the past 3 weeks. Due to hypotension, the patient received multiple boluses of isotonic saline and was started on norepinephrine. Laboratories were significant for severe digoxin toxicity (29 ng/mL), in setting...

Cardiac pacing through a transvenous catheter located in the right ventricle usually produces a pattern of left bundle branch block (LBBB). When right bundle branch block (RBBB) occurs during apparent right ventricular pacing, a complication (perforation or malposition of the catheter) has usually occurred. In the patient reported here, uncomplicated right ventricular transvenous pacing produce...

The aim of this study was to determine the diagnostic accuracy of myocardial perfusion SPECT (single photon emission computed tomography) with technetium labeling in patients with right bundle branch block (RBBB) and with left anterior hemiblock (LAH). One hundred seven patients (53 RBBB, 54 LAH) for whom coronary angiography results were available were selected. The gold standard for diagnosis...