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Related Experiment Videos

Abnormal septal motion in patients with postoperative right bundle branch block pattern

J Shapiro, R Boxer, E Krongrad

    American Heart Journal
    |February 1, 1979
    PubMed
    Summary

    Postoperative right bundle branch block uniquely affects septal motion, causing an early systolic notch. This specific echocardiographic pattern was not observed in control groups, highlighting its distinct nature.

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    Area of Science:

    • Cardiology
    • Cardiac Electrophysiology
    • Diagnostic Imaging

    Background:

    • Right bundle branch block (RBBB) is a common postoperative cardiac conduction abnormality.
    • Abnormal cardiac excitation patterns can influence myocardial mechanics, including septal motion.
    • Previous research has not fully characterized the specific impact of RBBB on septal dynamics post-surgery.

    Purpose of the Study:

    • To investigate the effects of postoperative right bundle branch block on septal motion using echocardiography.
    • To identify and describe any unique echocardiographic patterns associated with RBBB after cardiac surgery.
    • To differentiate RBBB-associated septal motion from normal or other abnormal patterns.

    Main Methods:

    • Echocardiograms were performed on 25 patients with postoperative RBBB pattern.

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  • Septal motion patterns were analyzed 3 to 93 months after surgery.
  • Control groups included 20 patients with normal QRS and 10 with right ventricular hypertrophy.

    • Main Results:

    • A unique pattern of septal motion was observed in all 25 RBBB patients: an early systolic anterior septal notch.
    • This notch occurred 70-80 msec after QRS onset, with anterior displacement of 2-7 mm and duration of 78-155 msec.
    • No such pattern was found in control groups, including those with normal conduction or right ventricular hypertrophy post-surgery.

    Conclusions:

    • Postoperative right bundle branch block is associated with a previously undescribed, unique echocardiographic pattern of septal motion.
    • This specific septal motion abnormality, characterized by an early systolic notch, is distinct and linked to RBBB.
    • Echocardiography can reveal unique cardiac excitation effects on myocardial motion in patients with conduction abnormalities.