title: Is It Complete Left Bundle Branch Block? Just Ablate the Right Bundle.
abstract: Complete left bundle branch block (LBBB) is established according to standard electrocardiographic criteria. However, functional LBBB may be rate-dependent or can perpetuate during tachycardia due to repetitive concealed retrograde penetration of impulses through the contralateral bundle "linking phenomenon." In this brief article, we present two patients with basal complete LBBB in whom ablating the right bundle unmasked the actual antegrade conduction capabilities of the left bundle. These cases highlight intriguing overlap between electrophysiological concepts of complete block, linking, extremely slow, and concealed conduction.
authors.affiliation: Arrhythmia and Electrophysiology Unit II, Humanitas Gavazzeni Clinics, Bergamo, Italy.
authors.forename: Hussam
authors.initials: H
authors.lastname: Ali
authors.affiliation: Arrhythmia and Electrophysiology Unit II, Humanitas Gavazzeni Clinics, Bergamo, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Lupo
authors.affiliation: Arrhythmia and Electrophysiology Unit II, Humanitas Gavazzeni Clinics, Bergamo, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Foresti
authors.affiliation: Arrhythmia and Electrophysiology Unit II, Humanitas Gavazzeni Clinics, Bergamo, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: De Ambroggi
authors.affiliation: Arrhythmia and Electrophysiology Unit II, Humanitas Gavazzeni Clinics, Bergamo, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Epicoco
authors.affiliation: Arrhythmia and Electrophysiology Unit II, Humanitas Gavazzeni Clinics, Bergamo, Italy.
authors.forename: Angelica
authors.initials: A
authors.lastname: Fundaliotis
authors.affiliation: Arrhythmia and Electrophysiology Research Center, Humanitas Clinical & Research Center, Rozzano, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Cappato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002036:Bundle of His / Q000503:physiopathology* / Q000601:surgery*; D002037:Bundle-Branch Block / Q000503:physiopathology* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D004562:Electrocardiography / Q000379:methods; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D016896:Treatment Outcome
keywords: bundle branch reentry; concealed conduction; left bundle branch block; right bundle ablation