Bilateral Partial Bundle Branch Block

Strauss, Sidney; Langendorf, Richard

doi:10.1097/00000441-194302000-00011

Cited by 19 publications

(2 citation statements)

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“…The changing QRS pattern seen in figures 3, 5, and 9, which represents the switching of exclusive pathways to the ventricles, also proves that apparently blocked pathways are capable of conduction and indicates that concealed transseptal retrograde penetration of the bundle branch sys-tem33'5 [39][40][41][42][43] or slow antegrade conduction may keep apparently blocked bundle branches in a refractory state. The QRS pattern of complete bundle branch block frequently means only that the transseptal conduction time" from the contralateral bundle branch is shorter than the conduction time of the apparently blocked bundle branch.…”

Section: Patientmentioning

confidence: 98%

Concealed intraventricular conduction in the His bundle electrogram.

Cohen¹,

D’Cruz²,

Pick³

1976

Circulation

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Multiple areas of concealed intraventricular conduction are deduced on the basis of aftereffects observed in His bundle recordings. Electrocardiograms and His bundle recordings are presented from two patients with unstable bilateral bundle branch block, the instability of which depended on the interval at which ventricular depolarization was initiated by sinus or paced impulses. This circumstance allows postulation of 1) concealed transseptal retrograde penetration of the left bundle branch system; 2) concealed transseptal retrograde penetration of the right bundle branch system; 3) alternate beat Wenckebach phenomenon with two areas of block in the bundle branch system with concealed penetration of the proximal area; 4) concealed re-entry in the right bundle branch system during an H-V Wenckebach cycle with resetting of the sequence of 2:1 H-V block and return of the re-entry wave to the A-V node causing subsequent A-H block; 5) proximal 2:1 block and distal Wenckebach block producing only two consecutively blocked beats; and 6) infrahisian Wenckebach block with changes both in A-V conduction and QRS contour.

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Section: Patientmentioning

confidence: 98%

Concealed intraventricular conduction in the His bundle electrogram.

Cohen¹,

D’Cruz²,

Pick³

1976

Circulation

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“…The second stage is not always characterized by the presence of a permanent block in one of the bundles and a partial one in the other. As several investigators have demonstrated (Strauss and Langendorf, 1943;Rosenbaum and Lepeschkin, 1955;Unger et al, 1958;Lepeschkin, 1964), the block could be partial in both bundles (more in one than in the other) and the patient might remain indefinitely in the second stage of disease. In these cases the electrocardiogram would show a bundle-branch block with an A-V conduction delay or alternating periods of right and left bundle-branch block.…”

mentioning

confidence: 99%

Electrocardiographic findings in patients with complete atrioventricular block.

Lopez¹

1968

Heart

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The introduction of the artificial electrical pacemaker for the treatment of patients with complete A-V block has been accompanied by renewed interest in the pathogenesis of this disorder. It has been considered that most cases of complete block are due to organic or functional lesions either in the A-V node or in the common A-V bundle. Barker conduction through both bundle-branches was unequally impaired. In both of these situations, one would observe a complete right or left bundlebranch block with prolongation of the P-R interval.Complete block would be the manifestation of failure of conduction through the more depressed branch, while prolongation of the P-R interval would be the manifestation of depressed conduction through the less impaired branch. They stressed that true bilateral bundle-branch block must show a prolonged A-V conduction time. Mahaim (1931), and more recently Lenegre and Moreau (1962), and Lenegre (1964), have conducted pathological studies in the hearts of patients who had complete A-V block. They confirmed the electrocardiographic impression that in the great majority of patients this type of block was due to an anatomical bilateral bundle-branch block.To elucidate further the relation between bilateral bundle-branch block and A-V block, we have analysed the records of all patients with complete A-V block admitted to the University Hospital, Saskatoon, in the five-year period between 1960 and 1965. Patients with surgical A-V block and those in whom the history and clinical diagnosis suggested digitalis toxicity were excluded. The results of our study form the basis of this communication.SUBJECTS AND RESULTS Between 1960 and 1965, 57 patients with an electrocardiographic diagnosis of complete A-V block were studied at the University Hospital. In many instances previous electrocardiograms were available. The age of the patient, the clinical history, and electrical axis in the frontal plane were carefully recorded.The 57 patients were divided into two main groups, according to the contour of the ventricular complexes during the periods of complete A-V

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Intraventricular Block

Rosenman¹

1950

Arch Intern Med (Chic)

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Bilateral Partial Bundle Branch Block

Cited by 19 publications

References 0 publications

Concealed intraventricular conduction in the His bundle electrogram.

Concealed intraventricular conduction in the His bundle electrogram.

Electrocardiographic findings in patients with complete atrioventricular block.

Intraventricular Block

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