Document Detail

Reassessment of Q waves in left bundle branch block.
MedLine Citation:
PMID:  1262769     Owner:  NLM     Status:  MEDLINE    
This study disputes a number of recent reports claiming that abnormal Q waves or a QS configuration in inferior leads (II, III and AVF) coexisting with left bundle branch block is highly suggestive of, and indeed specific for, myocardial infarction. Five patients reported herein demonstrate disappearance of Q waves in inferior leads on spontaneous reversal of LBBB to normal conduction. This necessitates the conclusion that these Q waves represent a postdivisional conduction variant most closely equivalent to left anterior fascicular block coexisting with predivisional LBBB. Absence of inferior R waves in the five patients demonstrating LBBB is explicable by as little as a 20 msec conduction delay in the posterior fascicle coexisting with a higher grade conduction defect in the anterior fascicle. It is concluded that LBBB with a QS configuration in II, III and AVF cannot be considered diagnostic of inferior wall infarction since it regularly results from impaired conduction of the left anterior and possibly the left posterior fascicle (to a lesser extent), which may be reversible.
G C Timmis; V Gangadharan; R G Ramos; S Gordon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  9     ISSN:  0022-0736     ISO Abbreviation:  J Electrocardiol     Publication Date:  1976 Apr 
Date Detail:
Created Date:  1976-07-06     Completed Date:  1976-07-06     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  109-14     Citation Subset:  IM    
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MeSH Terms
Bundle-Branch Block / complications,  diagnosis*
Coronary Disease / diagnosis
Diagnosis, Differential
Middle Aged
Myocardial Infarction / complications,  diagnosis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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