Reverse left septal activation during intermittent left bundle-branch block: indirect proof for concealed retrograde left bundle-branch activation.
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.
Maury
Philippe
P
Federation of Cardiology, University Hospital Rangueil, Toulouse Cedex 09, France. mauryjphil@hotmail.com
Duparc
Alexandre
A
Hébrard
Aurélien
A
Mondoly
Pierre
P
Rollin
Anne
A
Delay
Marc
M
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