Repetitive supernormal conduction in the right bundle branch in high degree bilateral bundle branch block.
Electrocardiograms were taken from a 67-year-old woman with high-degree atrioventricular block in which ventricular escape beats of right bundle branch block pattern occurred, accompanying occasional ventricular capture beats. Only when a sinus P wave occurred 0.60 s after the preceding escape beat, it was followed by a capture beat of left bundle branch block pattern with the RP interval of 0.60 s and the PR interval of 0.19 s. Similar left bundle branch block with left axis deviation pattern had been shown in the electrocardiogram taken 2 years before. Such RP and PR intervals in capture beats were invariable. These suggest that capture beats occurred as a result of supernormal conduction in the right bundle branch, which denies the possibility of ventricular extrasystoles. Such capture beats with the above RP and PR intervals were observed repeatedly.
Katoh
T
T
Katoh Cardiovascular Clinic, Ohtsu, Japan.
Kinoshita
S
S
Tsujimura
Y
Y
Sasaki
Y
Y
D000368:Aged; D002036:Bundle of His / Q000503:physiopathology*; D002037:Bundle-Branch Block / Q000503:physiopathology*; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans