Wandering Bundles With Sinus Arrhythmia

Song Yan; Li Wei; Gan-Xin Yan

doi:10.1016/j.jaccas.2023.101856

Wandering Bundles With Sinus Arrhythmia

JACC Case Rep. 2023 Apr 27:15:101856. doi: 10.1016/j.jaccas.2023.101856. eCollection 2023 Jun 7.

Authors

Song Yan¹, Li Wei¹, Gan-Xin Yan^{2

3

4}

Affiliations

¹ Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.
² Lankenau Medical Center, Main Line Health, Wynnewood, Pennsylvania, USA.
³ Fuwai Huazhong Hospital, Zhengzhou, Henan, China.
⁴ Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Abstract

A 3-year-old boy with congenital ventricular septal defect underwent a closure procedure. Telemetry after the procedure reveals sinus arrhythmia with varying types of bundle branch blocks. Inverse decremental conduction in left posterior fascicle, related to preceding RP interval during sinus arrhythmia, underlies changes between right and left bundle branch blocks. (Level of Difficulty: Advanced.).

Keywords: inverse decremental conduction; left bundle branch block; right bundle branch block; ventricular septal defect.