Abstract
The electrocardiographic changes associated with coronary arteriography were compared with those occurring during left ventricular catheterization in 16 patients. In 1 patient, a 36 year old man, transient left anterior divisional block was documented when the catheter tip was in the outflow tract of the left ventricle. The ÂQRS shifted from +90 to −50°, the initial 0.02 second QRS forces shifted interiorly and to the right, and the QRS interval increased from 0.07 to 0.09 second, fulfilling previously described criteria for the diagnosis of left anterior divisional block. This was attributed to transient injury of the anterior division of the left bundle branch. During recovery, several progressively decreasing degrees of left anterior divisional block were recorded. In the same patient and in the other 15, selective opacification of the coronary arteries shifted the main QRS forces, without change in the direction of the initial QRS forces. The axis shifts occurring during coronary arteriography are attributed to parietal block. Selective opacification of the coronary arteries does not affect the intraventricular conducting fascicles and Purkinje fibers.
Published Version
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