title: [Diagnosis of the myocardial inactivatable zone in the presence of right and bilateral intraventricular blocks].
abstract: The electro-vectorcardiographic manifestations of uncomplicated and complicated proximal and peripheral right conduction system blocks are described. In the presence of an advanced degree right bundle branch block (RBBB), the septal activation, which occurs with abnormal spreading, originates electromotive forces of greater duration and consequently of more importance than normal ones. Peripheral right blocks provoke a segmentary delay of right ventricle activation, producing asynchronism of the electrical phenomenon between upper and lower regions of the ipsilateral ventricle. The coexistence of an inactivatable anteroseptal zone with an advanced degree RBBB cause the phenomenon of "wave jumping" to begin in inferior posteroseptal regions. Therefore, the transitional leads see the first fronts of the said phenomenon moving away and register Q waves. The presence of a transmural inactivatable right parietal zone permits the corresponding external electrodes to record the morphology of the ipsilateral intraventricular complex. In certain cases a right anterior subdivision block (RASB) or a right posterior subdivision block (RPSB) can complicate with an inactivatable septal or ipsilateral septo-parietal zone, but these do not notably modify Q waves of the ventricular complex in the right leads.
authors.affiliation: Departamento de Electrocardiografía y Vectocardiografía, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
authors.forename: A
authors.initials: A
authors.lastname: de Micheli
authors.forename: G A
authors.initials: GA
authors.lastname: Medrano
mesh_terms: D004562:Electrocardiography; D006327:Heart Block / Q000503:physiopathology*; D006801:Humans; D009200:Myocardial Contraction; D014672:Vectorcardiography
vernacular_title: El diagnóstico de zona inactivable miocárdica con bloqueos intraventriculares derechos y bilaterales.