Bundle branch block in alternate beats during 2:1 atrial flutter

J Electrocardiol. 2006 Jan;39(1):38-41. doi: 10.1016/j.jelectrocard.2005.08.003. Epub 2005 Nov 9.

Abstract

This presentation deals with a case of atrial flutter. During 2:1 A/V conduction, the QRS complexes showed a regular alternation of narrow beats and wide beats with a typical configuration of left bundle branch block. In contrast, pauses resulting from 4:1 A/V conduction ratio always resulted in narrow beats. Disappearance of left bundle branch block with long R-R intervals demonstrated that the block was tachycardia-dependent or phase 3. Analysis of the tracing suggested that narrowing of QRS complexes in alternate beats was due to supernormal left bundle branch conduction associated with retrograde concealed conduction into the anterogradely blocked bundle branch.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Atrial Flutter / diagnosis*
  • Bundle-Branch Block / diagnosis*
  • Electrocardiography*
  • Female
  • Humans