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.
Arnau Vives
M A
MA
Cardiology Department, La Fe Hospital, Valencia, Spain.
Bonet
L A
LA
Lalaguna
L A
LA
Blasco
P M
PM
Dolz
L M
LM
Sáez
A O
AO
Pérez
M P
MP
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