Intermittent Bundle Branch Research Articles

Triple Pathway Longitudinal Dissociation in the His Bundle in a Patient with Intermittent Right Bundle Branch Block Pattern and Intermittent Rightward Shift

Triple Pathway Longitudinal Dissociation in the His Bundle in a Patient with Intermittent Right Bundle Branch Block Pattern and Intermittent Rightward Shift

Right bundle branch block with changing axis at the end of atrial fibrillation

Changing axis has been reported [1–8] also during atrial fibrillation [9–11] or atrial flutter [12,13]. Changing axis has been also reported during acute myocardial infarction [14–25] associated with atrial fibrillation too [26,27] or at the end of atrial fibrillation [28,29], also during acute myocardial infarction [30,31]. Dissimilar electrocardiographic patterns associated with right bundle branch block have been described [32]. Changing bundle branch block [14,33], new right bundle branchblock [34], rightbundle branchconductiondisturbances [35] and intermittent right bundle branch block [18] have also been reported in literature. We present a case of a right bundle branch block with changing axis at the end of atrial fibrillation in a 57-year-old Italian woman. A 57-year-old Italian woman was admitted to the Emergency Department with an atrial fibrillation. She reported the onset of palpitations approximately 2 h before. The ECG was performed and it showed a right bundle branch block with an atrial fibrillation (Fig. 1). The patientwas admitted to the Cardiology Unit. No pericardial effusion was observed at echocardiographic evaluation. After restoration of sinusal rhythm, the ECG showed right bundle branch block with changing axis and it was confirmed on ECG's surface performed on the following day (Fig. 2). Also this case focuses attention on changing axis.

Studies of acute myocardial infarction with intermittent bundle branch and hemiblock

Two cases of transient hemiblock occurring during the course of acute myocardial infarction are reported. The transient manifestation permits the accurate evaluation of the diagnostic features of the hemiblocks as modified by acute infarction. One case reflects the development of left bundle branch block due to bilateral post-divisional block which inter alia permits the study of left bundle branch block in the presence of acute myocardial infarction.

Effect of intermittent right bundle branch block on right ventricular contractility

I SOLATED right bundle branch block in man has been found to cause a slight delay in the onset of right ventricular contraction.1-5 This condition is occasionally present in an intermittent form with random alternation of normal and blocked beats6r7 In the present study right ventricular performance was evaluated in a patient with intermittent right bundle branch block. A change in the maximal rate of rise of right ventricular pressure from any given end-diastolic pressure was used as an index of a change in contractility.s-10 A preliminary report of this work has been presented.”