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Related Experiment Videos

Endocardial activation of left bundle branch block.

J A Vassallo, D M Cassidy, F E Marchlinski

    Circulation
    |May 1, 1984
    PubMed
    Summary

    Right ventricular activation precedes left ventricular activation in patients with left bundle branch block (LBBB). Left ventricular activation in LBBB is heterogeneous, with coronary artery disease patients showing longer activation times.

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    Area of Science:

    • Cardiology
    • Electrophysiology

    Background:

    • Left bundle branch block (LBBB) affects cardiac electrical conduction.
    • Understanding LBBB activation patterns is crucial for patient management.

    Purpose of the Study:

    • To investigate the endocardial activation sequence in patients with LBBB.
    • To compare activation times across different patient groups.

    Main Methods:

    • Endocardial catheter mapping in 18 patients with LBBB.
    • Patients categorized into three groups: no organic heart disease, cardiomyopathy, and coronary artery disease with infarction.
    • Analysis of left and right ventricular endocardial activation sites and times.

    Main Results:

    • Right ventricular activation consistently preceded left ventricular activation.

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  • Left ventricular endocardial activation occurred via right-to-left transseptal pathways.
  • Total left ventricular endocardial activation time was significantly longer in patients with coronary artery disease and LBBB compared to other groups.

    • Conclusions:

    • Right-to-left transseptal activation is the likely mechanism for left ventricular activation in LBBB.
    • Left ventricular activation patterns in LBBB are heterogeneous.
    • Coronary artery disease exacerbates delays in left ventricular activation in LBBB patients.