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[Right blocks in interauricular communication]

A de Micheli, G A Medrano, M A Martínez Rios

Archivos Del Instituto De Cardiologia De Mexico

|November 1, 1978

Summary

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Electrocardiography and vectorcardiography can differentiate right fascicular and truncular blocks in atrial septal defects. Specific criteria, including intrinsicoid deflection times and loop morphology, aid in diagnosis.

Area of Science:

Cardiology
Electrophysiology
Medical Imaging

Context:

Atrial septal defects (ASDs) can be associated with conduction abnormalities.
Differentiating right bundle branch blocks (RBBB) is crucial for patient management.

Purpose:

To establish electro-vectorcardiographic criteria for distinguishing right fascicular (distal) and truncular (proximal) blocks in ASD patients.
To analyze conduction disorders using conventional ECG, unipolar thoracic leads, intracavitary leads, and high-fidelity recordings.

Summary:

Vectorcardiography in 72 ASD cases identified proximal/truncular block (46 cases) with intrinsicoid deflection differences ≤30 msec.
Distal/fascicular block (26 cases) showed differences >30 msec, with specific lead findings for right anterior (RASB) and posterior (RPSB) blocks.

Related Experiment Videos

Loop morphology (SF and SH) and Q-Tc interval variations provided further diagnostic clues.

Impact:

Provides valuable diagnostic criteria for differentiating RBBB subtypes in ASD.
Highlights the utility of thoracic electric mapping for complex cases.
Correlates prolonged Q-Tc intervals with right ventricular diastolic pressure overload.