title: Abnormal septal motion in patients with postoperative right bundle branch block pattern.
abstract: Echocardiograms were performed on 25 patients with postoperative right bundle branch block pattern 3 to 93 months after surgery to assess the possible effects of abnormal cardiac excitation on septal motion. Each of the 25 patients demonstrated a unique pattern of septal motion characterized by the presence of an early systolic anterior septal notch, brief in duration and unrelated to subsequent systolic septal motion, right ventricular size, or surgical procedure. Beginning approximately 70 to 80 msec. after the initial QRS deflection, the septum abruptly moved anteriorly 2 to 7 mm. and then returned to a baseline position. The total duration of this abnormal septal motion lasted 78 to 155 msec. This echocardiographic pattern was not seen in any of 30 patients in two control groups. Twenty had a normal QRS pattern and ten demonstrated right ventricular hypertrophy. In addition, patients who underwent open heart surgery and had normal right ventricular conduction postoperatively did not show this echocardiographic pattern with either normal or paradoxical septal motion. This previously undescribed echocardiographic pattern demonstrates that septal motion is uniquely affected in patients with postoperative right bundle branch block pattern.
mesh_terms: D000293:Adolescent; D002037:Bundle-Branch Block / Q000503:physiopathology*; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000601:surgery; D006346:Heart Septum / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D011183:Postoperative Complications / Q000503:physiopathology