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Right bundle branch block with revelation of changing axis deviation at the end of atrial fibrillation

Salvatore Patanè, Filippo Marte, Mauro Sturiale

    International Journal of Cardiology
    |May 15, 2009
    PubMed

    Insights

    This study reports a rare case of right bundle branch block with changing axis deviation during atrial fibrillation in a 68-year-old man. This finding highlights complex ECG changes during cardiac events.

    Area of Science:

    • Cardiology
    • Electrocardiography

    Background:

    • Changing axis deviation is observed in atrial fibrillation, atrial flutter, and acute myocardial infarction.
    • Left bundle branch block typically presents with normal or left axis deviation.

    Observation:

    • Rarely, left bundle branch block can manifest with changing QRS morphology and axis deviation.
    • Intermittent right axis deviation in left bundle branch block during atrial fibrillation and myocardial infarction is infrequently reported.

    Findings:

    • The most likely cause of intermittent axis shifts in left bundle branch block is coexisting left posterior hemiblock and predivisional left bundle branch block.
    • This case presents a right bundle branch block with changing axis deviation revealed at the end of atrial fibrillation.

    Implications:

    • Understanding these rare ECG presentations is crucial for accurate diagnosis and management of complex cardiac conditions.
    • This case underscores the importance of considering combined conduction abnormalities and arrhythmias in myocardial infarction.

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