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Updated: Jul 15, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Atrial fibrillation with left bundle branch block and intermittent right axis deviation during acute myocardial

Salvatore Patanè, Filippo Marte, Gianluca Di Bella

    International Journal of Cardiology
    |April 10, 2007
    PubMed

    Insights

    This study discusses rare electrocardiogram (ECG) findings in a patient with acute myocardial infarction and atrial fibrillation. It highlights intermittent left or right axis deviation in the presence of left bundle branch block (LBBB).

    Area of Science:

    • Cardiology
    • Electrocardiography
    • Cardiac Electrophysiology

    Background:

    • Left bundle branch block (LBBB) is a common finding on electrocardiograms (ECGs).
    • Axis deviation in LBBB can indicate underlying cardiac conditions.
    • Intermittent axis deviation is a rare but significant electrocardiographic observation.

    Observation:

    • The case involved a 78-year-old woman with acute myocardial infarction and permanent atrial fibrillation.
    • Electrocardiogram (ECG) revealed left bundle branch block (LBBB) with changing QRS morphology.
    • Intermittent left and right axis deviations were observed in conjunction with LBBB and atrial fibrillation.

    Findings:

    • The intermittent positive aspect in lead aVR suggested intermittent right axis deviation during complete LBBB.
    • A concurrent left posterior fascicular block with pre-existing LBBB is proposed as the underlying mechanism.
    • The dynamic nature of axis deviation in LBBB was demonstrated.

    Implications:

    • This case underscores the importance of recognizing rare ECG patterns.
    • Understanding intermittent axis deviation in LBBB can aid in diagnosing complex cardiac conditions.
    • Further research into fascicular blocks accompanying LBBB is warranted for improved diagnostic accuracy.

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