Abstract
Clinically, the electrocardiographic patterns of bundle branch block are generally attributed to a corresponding anatomic lesion or lesions in the bundle branches. Contrary to these classic views, it can now be stated that a discrete lesion or an alteration in refractoriness within the His bundle may also result in similar electrocardiographic patterns of partial or complete bundle branch block. These conclusions are based on my recent study1 which documents asynchrony in conduction or longitudinal dissociation within the His bundle for the first time in man.
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