Humans ; Bundle-Branch Block/diagnosis*

No abstract available.
Bundle-Branch Block ; Heart Failure ; Heart ; Humans

Clinical electrophysilogical study(EPS) was done in 5 patients with chronic bifascicular block of completa RBBB and left anterior fascicular block. The results were as follows. 1) In 2 patients who needed permenent pacemaker therapy, EPS disclosed prolonged HV interval(>70msec) and block distal to his bundle by atrial with cycle length of longer than 545msec. 2) In 3 patients who didn't need permenent pacemaker therapy, AV conduction and to choose the therapeutic measures in the patients with chronic bifascicular block and unexplained dizziness and/or syncope.
Bundle of His ; Bundle-Branch Block ; Dizziness ; Humans ; Syncope

The position of interventricular septum, which was measured by transitional zone of EKG, was compared with that measured by 2-D echocardiography in 51 patient. 1) The position of interventricular septum measured by 2-D echocardiography was very similar to that measured by transitional zone of EKG. 2) Extensive AMI (Anterior Myocardial Infarction) and LBBB showed moderate differences between two method. 3) RBBB and replaced mitral valve state showed severe differences between two methods. Transitional zone of EKG was helpful to define the position of interventricular septum except extensive AMI, bundle branch block and replaced mitral valve state.
Bundle-Branch Block ; Echocardiography ; Electrocardiography* ; Humans ; Mitral Valve

No abstract available.
Brugada Syndrome* ; Bundle-Branch Block* ; Death, Sudden, Cardiac*

BACKGROUND AND OBJECTIVES: Long-term right ventricular (RV) apex pacing has been associated with left ventricular (LV) systolic dysfunction. However, pacing in the RV outflow tract (RVOT) is associated with a narrower QRS duration and may have a more normal LV activation in comparison to RV apical (RVA) pacing. We hypothesized that RVOT pacing is associated with less mechanical dyssynchrony compared to RVA pacing and that it also more closely resembles mechanical activation in normal controls with a narrow QRS. SUBJECTS AND METHODS: We studied 9 patients with RV pacing, 9 with left bundle branch block (LBBB), and 15 normal controls with a narrow QRS. In the RV pacing group, we paced from the RVA and RVOT. At the end of each pacing train, we obtained echocardiographic images in the apical 4- and 2-chamber views and obtained the following parameters: the compression/expansion crossover point (CEP) for myocardial strain and the time from QRS onset to the CEP in the strain image. The degree of dyssynchrony was evaluated using the dispersion and standard deviation of CEP times in 12 segments of the LV. RESULTS: Significant dyssynchrony was observed in the RVOT pacing group compared to the group with normal QRS. No significant difference was observed in LV mechanical dyssynchrony among the RVOT pacing, RVA pacing, and LBBB groups. CONCLUSION: RVOT pacing is associated with significant LV dyssynchrony. Although the RVOT has been recommended as an alternative site for pacing, this approach may have adverse effects on long-term LV function.
Bundle-Branch Block ; Heart Ventricles ; Humans ; Sprains and Strains

Electrocardiograms were observed in 168 patients with typhoid fever and were analyzed according to the duration of illness and hemoglobin level. The following results were obtained. 1) 124 patients out of 168 patients showed abnormal electrocardiographic findings. 2) The most prevalent abnormal findings were observed during third to fourth week of illness. 3) The lower the hemoglobin level, the higher frequency of electrocardiographic abnormalities were found. 4) Among the electrocardiographic disorders, sinus tachycardia was the most common finding and it was found in 60 cases(35.7%). The major abnormalities were ST-T change, low QRS voltage, prolongation of Q-T interval and prolongation of P-R interval: the over all incidence of these were 26.8%, 15.5%, 13.7% and 9.55 respectively. In addition to the major abnormalities, incomplete right bundle branch block (5.4%), premature ventricular contractions(3.0%) and abnormal Q wave(1.2%) were observed.
Bundle-Branch Block ; Electrocardiography* ; Humans ; Incidence ; Tachycardia, Sinus ; Typhoid Fever*

BACKGROUND AND OBJECTIVES: Conflicting data exist regarding the prognostic implication of ventricular conduction disturbance pattern in patients with heart failure (HF). This study investigated the prognostic impact of ventricular conduction pattern in hospitalized patients with acute HF. METHODS: Data from the Korean Acute Heart Failure registry were used. Patients were categorized into four groups: narrow QRS (<120 ms), right bundle branch block (RBBB), left bundle branch block (LBBB), and nonspecific intraventricular conduction delay (NICD). The NICD was defined as prolonged QRS (≥120 ms) without typical features of LBBB or RBBB. The primary endpoint was the composite of all-cause mortality or rehospitalization for HF aggravation within 1 year after discharge. RESULTS: This study included 5,157 patients. The primary endpoint occurred in 39.7% of study population. The LBBB group showed the highest incidence of primary endpoint followed by NICD, RBBB, and narrow QRS groups (52.5% vs. 49.7% vs. 44.4% vs. 37.5%, p<0.001). In a multivariable Cox-proportional hazards regression analysis, LBBB and NICD were associated with 39% and 28% increased risk for primary endpoint (LBBB hazard ratio [HR], 1.392; 95% confidence interval [CI], 1.152–1.681; NICD HR, 1.278; 95% CI, 1.074–1.520) compared with narrow QRS group. The HR of RBBB for the primary endpoint was 1.103 (95% CI, 0.915–1.329). CONCLUSIONS: LBBB and NICD were independently associated with an increased risk of 1-year adverse event in hospitalized patients with HF, whereas the prognostic impacts of RBBB were limited. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01389843
Bundle-Branch Block ; Heart Failure ; Heart ; Humans ; Incidence ; Mortality ; Prognosis

A contralateral bundle branch block (BBB) aberration during tachycardia with a preexisting BBB strongly suggests the presence of ventricular tachycardia. We report on a middle-aged, female patient presented with wide QRS tachycardia. The patient had orthodromic atrioventricular tachycardia with a left BBB aberration in the presence of a preexisting right BBB due to an abnormal His-Purkinje system. We learned that the contralateral BBB aberration with supraventricular tachycardia could be seen when the His-Purkinje system was abnormal.
Bundle of His ; Bundle-Branch Block* ; Female ; Humans ; Purkinje Fibers ; Tachycardia ; Tachycardia, Supraventricular* ; Tachycardia, Ventricular

Bundle of His ; Bundle-Branch Block ; Cardiac Pacing, Artificial ; Electrocardiography ; Humans ; Purkinje Fibers