Document Detail

The effect of intermittent bundle branch block on the coupling interval of ventricular premature depolarizations.
MedLine Citation:
PMID:  6181905     Owner:  NLM     Status:  MEDLINE    
The mechanism of origin of ventricular premature depolarizations (VPDs) is explained by automaticity or reentry. We studied three patients with intermittent left bundle branch block (LBBB) and unifocal VPDs of right bundle branch block (RBBB) morphology (assumed left ventricular origin). We examined the effect of different types of intraventricular conduction on the coupling intervals of the VPDs. Specifically, we proposed that the coupling intervals of VPDs would be longer during LBBB conduction of sinus beats (ipsilateral to the ventricle of origin of VPDs) compared with the coupling intervals during normal intraventricular conduction. We found that the coupling intervals during LBBB were significantly longer than those during normal conduction in all three cases (patient 1, 596 +/- 7 vs 484 +/- 5 msec; patient 2, 639 +/- 9 vs 534 +/- 11 msec; patient 3, 444 +/- 4 vs 382 +/- 9 msec) (p less than 0.005). We also examined the length of the preceding RR intervals and counted sinus beats intervening between successive VPDs (S values). One case demonstrated S values suggestive of concealed bigeminy; the other cases had S values suggesting concealed bigeminy and its variants. We have demonstrated that some VPDs are dependent on an initiating sinus beat. This dependence on a preceding beat is consistent with both a reentrant mechanism or triggered automaticity.
S A Biliack; P Denes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  66     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1982 Nov 
Date Detail:
Created Date:  1982-12-16     Completed Date:  1982-12-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1120-3     Citation Subset:  AIM; IM    
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MeSH Terms
Bundle-Branch Block / physiopathology*
Cardiac Complexes, Premature / physiopathology
Heart Conduction System / physiopathology
Heart Ventricles / physiopathology

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