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T-wave abnormalities of intermittent left bundle-branch block.
Annals of Internal Medicine
|August 1, 1978
Summary
Intermittent left bundle-branch block (LBBB) can cause T-wave abnormalities, mimicking ischemia. These changes may occur even without coronary artery disease, suggesting LBBB itself can induce them.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Intermittent left bundle-branch block (LBBB) is often linked to ischemia.
- T-wave abnormalities, particularly right precordial inversion, are observed in some LBBB patients.
Purpose of the Study:
- To investigate the clinical correlates of T-wave abnormalities in patients with intermittent LBBB.
- To determine if T-wave abnormalities suggest ischemia or can be induced by LBBB itself.
Main Methods:
- Analysis of 46 consecutive patients with intermittent LBBB.
- Examination of T-wave abnormalities during normally conducted beats and during LBBB conduction.
- Correlation with coronary heart disease status and coronary arteriograms.
Main Results:
- 72% of patients showed transient right precordial T-wave inversion, suggestive of ischemia.
- 17 patients with T-wave inversion had no coronary heart disease; 5 had normal arteriograms.
- T-wave abnormalities during LBBB conduction (48%) were more frequent than in permanent LBBB.
- Nine patients exhibited T-wave abnormalities during LBBB without coronary heart disease.
Conclusions:
- Right precordial T-wave inversion in intermittent LBBB may not always indicate ischemia.
- Recent LBBB itself can cause T-wave abnormalities, even in the absence of coronary artery disease.
- T-wave changes during LBBB conduction are also observed without significant coronary findings.