title: Reverse left septal activation during intermittent left bundle-branch block: indirect proof for concealed retrograde left bundle-branch activation.
abstract: Concealed retrograde activation of bundle branch has been often proposed for explaining the persistence of functional rate-dependent bundle-branch block, but direct proof of such a mechanism in man has rarely been demonstrated. We report intracardiac recordings compatible with a reversal of activation of the left basal interventricular septum during intermittent left bundle-branch block. In our case, however, retrograde activation into the left bundle-branch cannot be recordable, probably due to the concealment within the muscular septal activation, even if this may explain the perpetuation of bundle-branch block according to the linking phenomenon.
authors.affiliation: Federation of Cardiology, University Hospital Rangueil, Toulouse Cedex 09, France. mauryjphil@hotmail.com
authors.forename: Philippe
authors.initials: P
authors.lastname: Maury
authors.forename: Alexandre
authors.initials: A
authors.lastname: Duparc
authors.forename: Aurélien
authors.initials: A
authors.lastname: Hébrard
authors.forename: Pierre
authors.initials: P
authors.lastname: Mondoly
authors.forename: Anne
authors.initials: A
authors.lastname: Rollin
authors.forename: Marc
authors.initials: M
authors.lastname: Delay
mesh_terms: D000328:Adult; D002037:Bundle-Branch Block / Q000175:diagnosis*; D004562:Electrocardiography / Q000379:methods*; D005188:False Negative Reactions; D005260:Female; D006329:Heart Conduction System / Q000002:abnormalities*; D006343:Heart Septal Defects; D006801:Humans