Reverse left septal activation during intermittent left bundle-branch block: indirect proof for concealed retrograde left bundle-branch activation

J Electrocardiol. 2009 Nov-Dec;42(6):671-3. doi: 10.1016/j.jelectrocard.2009.04.007. Epub 2009 Jun 10.

Abstract

Concealed retrograde activation of bundle branch has been often proposed for explaining the persistence of functional rate-dependent bundle-branch block, but direct proof of such a mechanism in man has rarely been demonstrated. We report intracardiac recordings compatible with a reversal of activation of the left basal interventricular septum during intermittent left bundle-branch block. In our case, however, retrograde activation into the left bundle-branch cannot be recordable, probably due to the concealment within the muscular septal activation, even if this may explain the perpetuation of bundle-branch block according to the linking phenomenon.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bundle-Branch Block / diagnosis*
  • Electrocardiography / methods*
  • False Negative Reactions
  • Female
  • Heart Conduction System / abnormalities*
  • Heart Septal Defects*
  • Humans