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[Left axis deviation investigated by body surface mapping and phase image analysis].

M Sakurai, Y Watanabe, T Kondo

    Journal of Cardiography
    |March 1, 1986
    PubMed
    Summary
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    Left anterior fascicular block (LAFB) is linked to specific ventricular activation patterns in patients with right bundle branch block and left axis deviation. These patterns, identified through body surface mapping and radionuclide imaging, help diagnose fascicular blocks.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Medical Imaging

    Background:

    • Left axis deviation (LAD) can be associated with left anterior fascicular block (LAFB).
    • Understanding ventricular activation sequences is crucial for diagnosing conduction abnormalities.

    Purpose of the Study:

    • To investigate the relationship between LAD and LAFB.
    • To correlate ventricular excitation and contraction sequences with specific block patterns.

    Main Methods:

    • Body surface potential mapping (isochrone ventricular activation maps).
    • Phase image analysis using radionuclide ventriculography (planar and tomographic).
    • Inclusion of normal subjects, RBBB, RBBB with LAD, and isolated LAD patients.

    Main Results:

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    • Right bundle branch block (RBBB) showed delayed right ventricular conduction but normal left ventricular activation.
    • RBBB with LAD was categorized into three types based on left ventricular activation patterns.
    • Type II activation correlated with left anterosuperior fascicular block; Type III with broader damage including midseptal fascicles.

    Conclusions:

    • Specific ventricular activation patterns support the diagnosis of LAFB in RBBB with LAD.
    • Tomographic and planar phase imaging revealed delays consistent with LAFB.
    • Extensive damage, including midseptal fascicles, is suspected in cases with LAD beyond -30 degrees.