Left Bundle Branch Block and Intermittent Type A Preexcitation

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In an analysis of over 100,000 electrocardiographic records, Pick and Fisch 1 Pick A Fisch C Ventricular preexcitation (WPW) in the presence of bundle branch block. Am Heart J. 1958; 55: 504-512 Abstract Full Text PDF PubMed Scopus (19) Google Scholar found that the incidence of bundle branch block was 3 percent, and that of preexcitation 0.08 percent. Assuming that these two entities have different anatomic substrates, and are independent, the statistical chance of their occurring together is about 0.0024 percent. There are a number of publications that report the coexistence of preexcitation and bundle branch block. Most of these demonstrate association of right bundle branch block (RBBB) with preexcitation. 1 Pick A Fisch C Ventricular preexcitation (WPW) in the presence of bundle branch block. Am Heart J. 1958; 55: 504-512 Abstract Full Text PDF PubMed Scopus (19) Google Scholar , 2 Cabrera E Feldman J Olinto FC Estudio electro y vectorcardiografico en un caso de Wolff-Parkinson-White en bloques de rama derecha. Arch Inst Cardiol Mexico. 1959; 29: 404-408 PubMed Google Scholar , 3 Castellanos Jr, A Mayer JW Lemberg L The electrocardiogram and vectorcardiogram in Wolff-Parkinson-White syndrome associated with bundle branch block. Am J Cardiol. 1962; 10: 657-665 Abstract Full Text PDF Scopus (17) Google Scholar , 4 Gamboa R Penaloza D Sime F et al. The role of the right and left ventricles in the ventricular preexcitation (WPW) syndrome. Am J Cardiol. 1962; 10: 650-657 Abstract Full Text PDF PubMed Scopus (9) Google Scholar , 5 Robertson PGC Ernslie-Smith D Lowe KG et al. The association of type B ventricular preexcitation and right bundle branch block. Br Heart J. 1963; 25: 755-761 Crossref PubMed Scopus (10) Google Scholar , 6 Zakopoulos KS Tsatas A Th Liokis TI Type B Wolff-Parkinson-White syndrome associated with right bundle branch block. Dis Chest. 1964; 46: 346-347 Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar , 7 Schamroth L Kirkler D Location of the preexcitation areas in the Wolff-Parkinson-White syndrome. Am J Cardiol. 1967; 19: 889-891 Abstract Full Text PDF PubMed Scopus (7) Google Scholar , 8 Scherf D Borhemann C Two unusual cases of preexcitation. J Electrocardiol. 1969; 2: 177-184 Abstract Full Text PDF PubMed Scopus (3) Google Scholar , 9 Gerson WM Ekery DD Concealed right bundle branch block in the presence of type B ventricular preexcitation. Am Heart J. 1969; 77: 660-676 Google Scholar , 10 Massumi RA His bundle recordings in bilateral bundle branch block combined with Wolff-Parkinson-White syndrome. Circ. 1970; 42: 287-295 Crossref PubMed Google Scholar , 11 Sobrino J Mate I Munoz JE et al. Disappearance of right bundle branch block with left anterior hemiblock when associated with a type B preexcitation syndrome. Am Heart J. 1974; 87: 497-500 Abstract Full Text PDF PubMed Scopus (3) Google Scholar Fewer reports demonstrate the coexistence of left bundle branch block (LBBB) and ventricular preexcitation. 1 Pick A Fisch C Ventricular preexcitation (WPW) in the presence of bundle branch block. Am Heart J. 1958; 55: 504-512 Abstract Full Text PDF PubMed Scopus (19) Google Scholar , 3 Castellanos Jr, A Mayer JW Lemberg L The electrocardiogram and vectorcardiogram in Wolff-Parkinson-White syndrome associated with bundle branch block. Am J Cardiol. 1962; 10: 657-665 Abstract Full Text PDF Scopus (17) Google Scholar , 8 Scherf D Borhemann C Two unusual cases of preexcitation. J Electrocardiol. 1969; 2: 177-184 Abstract Full Text PDF PubMed Scopus (3) Google Scholar