[The kinetocardiogram in complete left bundle branch block. Correlations between the kinetocardiogram and systolic...

The authors studied the possible correlations between the behaviour of the systolic time intervals, as measured by the electrophonosphygmographic patterns, and the behaviour of the kinetocardiogram recorded on left precordium, in 23 cases of complete LBBB. The results tend to confirm the possibility of distinguishing the distal from the proximal level of the conduction defect in a non invasive way, as already indicated in literature. Evidence for the former is the observation of a lengthening of the isovolumetric contraction time, of an increase of the PEP/LVET and ICT/LVET ratios, of a pansystolic bulge in KCG with a pathological amplitude of the atrial waves, all showing a left ventricular dysfunction. Evidence for a proximal level of conduction defect is: the normal length of the ICT, the normal PEP/LVET and ICT/LVET ratios, the absence of pathological atrial waves in KCG. The presence of paradoxical outward movement (POM) in KCG also in the latter case, even though only rarely observable as a pansystolic bulge, could be related to the existence of a form of ventricular dyssynergy, due to the deranged conduction of the impulse (ventricular dyskinesis from inter- or intra-ventricular asynchrony).