Left ventricular end-diastolic extrasystole with pseudonormalization of a left bundle branch block unmasking inferior ischemia.
An electrocardiogram tracing of a patient in conducted sinus rhythm with left bundle branch block is shown, in which occasional pseudonormalization of intraventricular conduction is seen. This event is attributed to ventricular fusions with end-diastolic extrasystoles of the left His-Purkinje system distal to the block site. This type of extrasystole is discussed. In this case, normalization of ventricular activation allowed for diagnosis of inferior subepicardial ischemia.
Cardiology Department, La Fe Hospital, Valencia, Spain.
M A
MA
Arnau Vives
L A
LA
Bonet
L A
LA
Lalaguna
P M
PM
Blasco
L M
LM
Dolz
A O
AO
Sáez
M P
MP
Pérez
D002037:Bundle-Branch Block / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D003937:Diagnosis, Differential; D003971:Diastole; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D018879:Ventricular Premature Complexes / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology