Abstract
Summary The vectorcardiograms (VCGs) of 48 patients with complete right bundle branch block combined with marked left axis deviation were studied and compared with electrocardiographic and clinical data. In these patients the VCG enables two patterns to be separated, i.e., type A (28 cases) and B (11 cases), with a different position and rotation of the horizontal loop. Type A configuration is similar to uncomplicated RBBB. Type B shows an anteriorly displaced loop with clockwise rotation. The ECG fails to distinguish type A from B. Contrary to the hypothesis of others, data are presented indicating that an associated posterior infarction cannot be, at least in some cases, the explanation for type B pattern. Type B reveals a more serious prognosis than type A mainly as regards the tendency to develop complete A-V block (18% as against 75%). This fact can suggest a new potential clinical usefulness for the VCG.
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