Left-sided intraventricular conduction delay concealed by right bundle branch block

Agustin Castellanos; Freddy del Carpio Munoz; Jose A Martel

doi:10.1016/j.jelectrocard.2007.11.002

Left-sided intraventricular conduction delay concealed by right bundle branch block

J Electrocardiol. 2008 Jul-Aug;41(4):357-9. doi: 10.1016/j.jelectrocard.2007.11.002. Epub 2008 Mar 14.

Authors

Agustin Castellanos¹, Freddy del Carpio Munoz, Jose A Martel

Affiliation

¹ Division of Cardiology, Department of Medicine of the University of Miami Miller School of Medicine, Miami, FL, USA. acastell@med.miami.edu

PMID: 18342878
DOI: 10.1016/j.jelectrocard.2007.11.002

Abstract

The electrocardiograms of a 69-year-old woman with severe heart failure showed a left-sided nonspecific intraventricular conduction delay (QRS duration, 0.13 seconds) characterized by notches and slurrings in the descending part of the R waves in the left precordial leads and in the ascending parts of the S waves in the right precordial leads. Subsequently, a complete right bundle branch block with wider QRS complexes (0.17 seconds) appeared. It is possible to consider that the left-sided nonspecific intraventricular conduction delay was concealed by the greater conduction delay occurring when the complete right bundle branch block was present. This would be in keeping with a previous study using Doppler tissue imaging in which this was postulated but where the corresponding electrocardiograms were not shown.

Publication types

Case Reports

MeSH terms

Aged
Arrhythmias, Cardiac / complications*
Arrhythmias, Cardiac / diagnosis*
Bundle-Branch Block / complications*
Bundle-Branch Block / diagnosis*
Diagnosis, Differential
Electrocardiography*
Female
Humans
Ventricular Dysfunction, Left / complications*
Ventricular Dysfunction, Left / diagnosis*